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Timing and Morbidity of Intracranial Meningioma Resection Complications
Henry Stonnington1, Ataollah Shahbandi2, George Bcharah1
1Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, USA.
Background:
Intracranial meningioma resection is associated with multiple acute postoperative complications, including cerebrovascular accidents, surgical site infections, and pneumonia. There is a paucity of research on the postoperative timeframe of these complications. Therefore, our objective is to characterize intracranial meningioma resection complications' time courses.
Methods:
The National Surgical Quality Improvement Project registry was queried for intracranial meningioma resection cases using CPT codes 61512 and 61519 from years 2016 to 2021. Baseline patient characteristics and 30-day complication frequency were calculated. The mean, median, and interquartile range of postoperative days to occurrence for 17 complications were calculated. Percent incidence predischarge was recorded. Time-to-occurrence curves were created. Rates of 30-day mortality and increased length-of-stay were compared between patients with and without each complication using a χ2 test. A covariance matrix showing associations between 11 complications using the Pearson method was made. Significance was set at P < 0.05.
Results:
Ten thousand eight hundred ninety cases were analyzed. The most frequent complications' median and interquartile range of postoperative days to occurrence and percentage occurring predischarge were bleeding requiring transfusion (0.0, 0.0-0.0, 99.9%), cerebrovascular accident/stroke with neurological deficit (2.0, 1.0-6.0, 83.8%), unplanned intubation (4.0, 1.0-8.0, 75.1%), on a ventilator for >48 hours (3.0; 2.0-5.5; 88.1%), deep vein thrombosis/thrombophlebitis (12.5, 5.2-19.7, 41.3%), urinary tract infection (13.0, 7.0-20.0, 44.2%), pneumonia (8.0, 4.0-16.0, 60.5%), and pulmonary embolism (14.0, 6.0-20.0, 29.1%). Most complications were associated with increased mortality and length-of-stay.
Conclusions:
Postoperative meningioma resection complications have varying morbidity and timeframes. Surgeons should be aware of complication timing to better manage postoperative care.
Insights
This study analyzed postoperative complications after intracranial meningioma resection. It found that complications like bleeding and stroke occur early, while infections and embolisms manifest later, impacting patient outcomes.
Area of Science:
- Neurosurgery
- Surgical Outcomes
- Public Health
Background:
- Intracranial meningioma resection is linked to acute postoperative complications.
- Research on the timing of these complications is limited.
- Understanding complication timelines is crucial for patient management.
Purpose of the Study:
- To characterize the time course of acute postoperative complications following intracranial meningioma resection.
- To identify the temporal patterns of specific morbidities.
- To inform clinical practice regarding postoperative surveillance and management.
Main Methods:
- Utilized the National Surgical Quality Improvement Project registry (2016-2021).
- Analyzed intracranial meningioma resection cases (CPT codes 61512, 61519).
- Calculated complication frequencies, time-to-occurrence, and associated outcomes (mortality, length-of-stay).
Main Results:
- Analyzed 10,890 cases; identified varying complication timeframes.
- Early complications included bleeding (99.9% predischarge), stroke (median 2 days), and intubation (median 4 days).
- Later complications included deep vein thrombosis (median 12.5 days) and pulmonary embolism (median 14 days).
Conclusions:
- Postoperative complications following meningioma resection exhibit diverse temporal patterns.
- Awareness of specific complication timing is essential for optimizing postoperative care.
- Timely recognition and management of these complications can improve patient outcomes and reduce healthcare burden.
