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Predicting High-Value Care Outcomes After Surgery for Non-Skull Base Meningiomas
Adrian E Jimenez1, Sachiv Chakravarti1, Sophie Liu1
1Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
World Neurosurgery
|December 13, 2021
Summary
Predictive models identify patients at risk for prolonged hospital stay, nonroutine discharge, or readmission after non-skull base meningioma surgery. An online calculator aids in assessing these adverse postoperative outcomes.
Area of Science:
- Neurosurgery
- Oncology
- Health Services Research
Background:
- Meningiomas are common primary brain tumors, with non-skull base locations requiring surgical resection.
- Understanding prognostic factors for postoperative outcomes is crucial for high-value care.
- Predictive models can help identify patients at risk for adverse events.
Purpose of the Study:
- To develop predictive models for extended hospital length of stay (LOS).
- To identify predictors for nonroutine discharge disposition.
- To determine risk factors for 90-day hospital readmission after non-skull base meningioma surgery.
Main Methods:
- Analysis of 396 patients undergoing non-skull base meningioma resection (2005-2020).
- Bivariate analysis using Mann-Whitney U and Fisher exact tests.
- Multivariate analysis employing logistic regression models.
Main Results:
- Nonelective surgery and increased tumor volume predicted prolonged LOS (>4 days).
- Male sex, nonmarried status, nonelective surgery, specific tumor locations, and higher frailty scores predicted nonroutine discharge.
- Nonprivate insurance and nonmarried status predicted 90-day readmission.
Conclusions:
- Predictive models for prolonged LOS, nonroutine discharge, and readmission were developed.
- An open-access online calculator was created based on these models.
- The calculator can assist in assessing postoperative risks for non-skull base meningioma patients.
