Safety of craniotomy for brain tumor resection in octogenarians and older patients - a matched - cohort analysis.

in The International journal of neuroscience by Raphael Augusto Corrêa Bastianon Santiago, Assad Ali, Bilal Ibrahim, Mauricio Mandel, Baha'eddin A Muhsen, Michal Obrzut, Surabhi Ranjan, Hamid Borghei-Razavi, Badih Adada

TLDR

  • The study found no significant difference in 30-day readmission, 30-day mortality, or post-operative complications between octogenarian and younger patients undergoing craniotomy for brain tumor resection.
  • A longer length of stay was observed in older patients, and KPS was significantly different between the two groups.
  • The study's findings suggest that octogenarians can undergo craniotomy without a significant increase in post-operative complications or mortality

Abstract

The incidence of brain tumors has increased in elderly population overtime. Their eligibility to a major surgery remains a questionable subject. This study evaluated prognostic factors and 30-days morbidity and mortality in octogenarian population who underwent craniotomy for resection of brain tumor. A total of 154 patients were divided into two different groups: patients above 80 years old and patients below 65 years old. In both groups, patients were stratified based on diagnosis with benign tumors [meningioma] and malignant tumors [high-grade gliomas and metastases]. Multivariable logistic regression model with backward elimination method was utilized to identify the independent risk factors for 30-days readmission and post-operative complications. The analysis revealed no significant difference in 30-day readmission (= 0.7329), 30-day mortality (0.6854) or in post-operative complication (= 0.3291) between age ≥ 80 and age ≤ 65 groups. A longer length of stay (LOS) was observed in the older patients (= 0.0479). There was a significant difference in the pre-post KPS between the two groups (< 0.0001). ASA (= 0.0315) and KPS (= 0.071) were found as important prognostic factors associated with post-operative mortality in both groups. Octogenarians can withstand craniotomy without any significant increase in 30-day readmission, 30-day mortality and post-operative complications as compared to patients younger than age 65. The ASA score (>3) and/or KPS (<70) were the most important prognostic factors for 30-days readmission and mortality.

Overview

  • The study aimed to evaluate prognostic factors and 30-days morbidity and mortality in octogenarian patients who underwent craniotomy for brain tumor resection.
  • A total of 154 patients were divided into two groups: patients above 80 years old and patients below 65 years old, and stratified based on diagnosis with benign or malignant tumors.
  • The primary objective was to identify the independent risk factors for 30-days readmission and post-operative complications in older adult patients undergoing craniotomy for brain tumor resection

Comparative Analysis & Findings

  • No significant difference was observed in 30-day readmission, 30-day mortality, or post-operative complications between the age ≥ 80 and age ≤ 65 groups.
  • A longer length of stay (LOS) was observed in the older patients compared to younger patients.
  • Significant differences were noted in pre- and post-operative KPS between the two groups

Implications and Future Directions

  • The study suggests that octogenarians can withstand craniotomy without any significant increase in 30-day readmission, 30-day mortality and post-operative complications compared to patients younger than age 65.
  • Further research is needed to investigate the impact of age on post-operative morbidity and mortality in brain tumor patients.
  • The ASA score (> 3) and/or KPS (< 70) were found to be important prognostic factors for 30-day readmission and mortality
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