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Surgical risk factors for post-operative pneumonia following meningioma resection
Taemin Oh1, Michael Safaee2, Matthew Z Sun2
1Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Objective:
Post-operative pneumonia (PNA) is a significant cause of surgically associated morbidity and mortality. We aimed to identify intraoperative factors during meningioma surgery that were associated with a high risk of post-operative PNA to risk-stratify patients and improve outcomes.
Methods:
We conducted an institutional retrospective review on all patients who underwent craniotomies for meningioma between 2009 and 2012. Using medical records, we extracted patient demographics, tumor characteristics, tumor pathology, surgical positioning, procedure duration, estimated blood loss (EBL), and the occurrence of post-operative PNA.
Results:
In our series, 464 patients underwent craniotomy for meningioma. There was a female predominance (331 women, 133 men), with mean age of 58±13 years (range 18-92). There were 354 grade I, 79 grade II, and 30 grade III tumors. Overall, 1.3% of patients developed PNA. Patient age (p=0.01), procedure duration (p<0.01), and blood loss (p=0.02) were associated with increased incidence of PNA. The development of post-operative PNA resulted in a significantly increased duration of hospital stay (19±7 vs. 7±7 days, p=0.00). In multivariate analysis, patient age (OR=1.13, CI: 1.04-1.22; p=0.004), EBL (OR=1.01, CI: 1.00-1.02; p=0.023), and procedure duration (OR=1.06, CI: 1.01-1.11; p=0.012) were significant predictors of development of PNA.
Conclusions:
Patient age and procedure duration are significantly associated with post-operative PNA following meningioma resection, which results in prolonged hospitalization. Efforts to minimize operative times and EBL, especially in the elderly, may reduce PNA rates and hospitalization time.
Insights
Post-operative pneumonia (PNA) after meningioma surgery is linked to patient age and longer procedure times. Minimizing operative duration and blood loss, particularly in older patients, can help reduce PNA rates and hospital stays.
Area of Science:
- Neurosurgery
- Oncology
- Critical Care Medicine
Background:
- Post-operative pneumonia (PNA) is a major complication following surgical procedures, contributing to increased morbidity and mortality.
- Meningioma surgery, while often successful, carries risks including respiratory complications like PNA.
- Identifying pre-operative and intra-operative risk factors is crucial for patient stratification and outcome improvement.
Purpose of the Study:
- To identify intraoperative factors associated with a high risk of post-operative pneumonia (PNA) in patients undergoing meningioma surgery.
- To enable risk stratification for patients undergoing meningioma resection.
- To guide strategies for improving patient outcomes and reducing complications.
Main Methods:
- Retrospective review of patients who underwent craniotomies for meningioma between 2009 and 2012.
- Extraction of data including patient demographics, tumor characteristics, surgical positioning, procedure duration, and estimated blood loss (EBL).
- Statistical analysis to identify factors associated with the development of post-operative PNA.
Main Results:
- A total of 464 patients were included in the study.
- Post-operative pneumonia (PNA) occurred in 1.3% of patients.
- Significant predictors of PNA included patient age (p=0.004), estimated blood loss (EBL) (p=0.023), and procedure duration (p=0.012).
Conclusions:
- Patient age and procedure duration are significantly associated with post-operative PNA after meningioma resection.
- Post-operative pneumonia leads to a significant increase in hospitalization duration.
- Minimizing operative times and blood loss, especially in elderly patients, may reduce PNA incidence and shorten hospital stays.
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