Brain and Spine (Jan 2021)
The association of patient age with postoperative morbidity and mortality following resection of intracranial tumors
- Yang Yang,
- Anna M. Zeitlberger,
- Marian C. Neidert,
- Victor E. Staartjes,
- Morgan Broggi,
- Costanza Maria Zattra,
- Flavio Vasella,
- Julia Velz,
- Jiri Bartek, Jr.,
- Alexander Fletcher-Sandersjöö,
- Petter Förander,
- Darius Kalasauskas,
- Mirjam Renovanz,
- Florian Ringel,
- Konstantin R. Brawanski,
- Johannes Kerschbaumer,
- Christian F. Freyschlag,
- Asgeir S. Jakola,
- Kristin Sjåvik,
- Ole Solheim,
- Bawarjan Schatlo,
- Alexandra Sachkova,
- Hans Christoph Bock,
- Abdelhalim Hussein,
- Veit Rohde,
- Marike L.D. Broekman,
- Claudine O. Nogarede,
- Cynthia M.C. Lemmens,
- Julius M. Kernbach,
- Georg Neuloh,
- Niklaus Krayenbühl,
- Paolo Ferroli,
- Luca Regli,
- Oliver Bozinov,
- Martin N. Stienen
Affiliations
- Yang Yang
- Department of Neurosurgery, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland; Department of Neurosurgery, University Hospital Zurich and Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland
- Anna M. Zeitlberger
- Department of Neurosurgery, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
- Marian C. Neidert
- Department of Neurosurgery, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland; Department of Neurosurgery, University Hospital Zurich and Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland
- Victor E. Staartjes
- Department of Neurosurgery, University Hospital Zurich and Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland
- Morgan Broggi
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Department of Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Costanza Maria Zattra
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Flavio Vasella
- Department of Neurosurgery, University Hospital Zurich and Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland
- Julia Velz
- Department of Neurosurgery, University Hospital Zurich and Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland
- Jiri Bartek, Jr.
- Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience and Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
- Alexander Fletcher-Sandersjöö
- Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience and Medicine, Karolinska Institutet, Stockholm, Sweden
- Petter Förander
- Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience and Medicine, Karolinska Institutet, Stockholm, Sweden
- Darius Kalasauskas
- Department of Neurosurgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
- Mirjam Renovanz
- Department of Neurosurgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
- Florian Ringel
- Department of Neurosurgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
- Konstantin R. Brawanski
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
- Johannes Kerschbaumer
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
- Christian F. Freyschlag
- Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria
- Asgeir S. Jakola
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden
- Kristin Sjåvik
- Department of Neurosurgery, University Hospital of North Norway, Tromsö, Norway
- Ole Solheim
- Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway
- Bawarjan Schatlo
- Department of Neurosurgery, Georg August University, University Medical Center, Göttingen, Germany
- Alexandra Sachkova
- Department of Neurosurgery, Georg August University, University Medical Center, Göttingen, Germany
- Hans Christoph Bock
- Department of Neurosurgery, Georg August University, University Medical Center, Göttingen, Germany
- Abdelhalim Hussein
- Department of Neurosurgery, Georg August University, University Medical Center, Göttingen, Germany
- Veit Rohde
- Department of Neurosurgery, Georg August University, University Medical Center, Göttingen, Germany
- Marike L.D. Broekman
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, the Netherlands; Department of Neurosurgery, Leiden University Medical Center, Leiden, the Netherlands
- Claudine O. Nogarede
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, the Netherlands; Department of Neurosurgery, Leiden University Medical Center, Leiden, the Netherlands
- Cynthia M.C. Lemmens
- Department of Neurology, Haaglanden Medical Center, The Hague, the Netherlands
- Julius M. Kernbach
- Department of Neurosurgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Georg Neuloh
- Department of Neurosurgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Niklaus Krayenbühl
- Department of Neurosurgery, University Hospital Zurich and Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland
- Paolo Ferroli
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Luca Regli
- Department of Neurosurgery, University Hospital Zurich and Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland
- Oliver Bozinov
- Department of Neurosurgery, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
- Martin N. Stienen
- Department of Neurosurgery, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland; Department of Neurosurgery, University Hospital Zurich and Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland; Corresponding author. Fellow of the European Board of Neurological Surgeons, Department of Neurosurgery, Cantonal Hospital St.Gallen, Rorschacher Strasse 95, 9007, St.Gallen, Switzerland.
- Journal volume & issue
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Vol. 1
p. 100304
Abstract
Introduction: The postoperative functional status of patients with intracranial tumors is influenced by patient-specific factors, including age. Research question: This study aimed to elucidate the association between age and postoperative morbidity or mortality following the resection of brain tumors. Material and methods: A multicenter database was retrospectively reviewed. Functional status was assessed before and 3–6 months after tumor resection by the Karnofsky Performance Scale (KPS). Uni- and multivariable linear regression were used to estimate the association of age with postoperative change in KPS. Logistic regression models for a ≥10-point decline in KPS or mortality were built for patients ≥75 years. Results: The total sample of 4864 patients had a mean age of 56.4 ± 14.4 years. The mean change in pre-to postoperative KPS was −1.43. For each 1-year increase in patient age, the adjusted change in postoperative KPS was −0.11 (95% CI -0.14 - - 0.07). In multivariable analysis, patients ≥75 years had an odds ratio of 1.51 to experience postoperative functional decline (95%CI 1.21–1.88) and an odds ratio of 2.04 to die (95%CI 1.33–3.13), compared to younger patients. Discussion: Patients with intracranial tumors treated surgically showed a minor decline in their postoperative functional status. Age was associated with this decline in function, but only to a small extent. Conclusion: Patients ≥75 years were more likely to experience a clinically meaningful decline in function and about two times as likely to die within the first 6 months after surgery, compared to younger patients.
