The social deprivation index and perioperative outcomes following meningioma resection

The Social Deprivation Index (SDI) is a validated measure of neighborhood-level socioeconomic disadvantage. Its impact on perioperative outcomes following meningioma resection remains underexplored.

We retrospectively analyzed patients who underwent intracranial meningioma resection at a single tertiary academic institution from 2011 to 2023, stratified by SDI quartile (Q1 to Q4). Outcomes included baseline characteristics, operative parameters, complications, readmissions, and functional status.

In our analysis of 887 patients, we found that higher SDI quartiles had greater comorbidity burden, with hypertension, COPD, and obesity more prevalent, as well as higher rates of non-White race and Hispanic ethnicity. The total number of comorbidities increased progressively from Q1 to Q4 (p = 0.001). Tumor grade, volume, and operative time were generally similar across quartiles, but ASA class III-IV status was more common in Q4 (p = 0.002), and skull base tumors were more frequent in higher quartiles (p = 0.010). Multivariable regression revealed that patients in Q2 and Q4 had significantly longer operative times compared to Q1 (p = 0.018; p = 0.031). Functional outcomes demonstrated an unexpected finding: patients in Q3 showed greater improvement in postoperative mRS compared to Q1 (p = 0.010). No significant differences were found in change in KPS, EBL, LOS, or hospital charges. On univariable and multivariable logistic regression, Q4 patients had significantly increased odds of non-neurological complications compared to Q1 (p = 0.016). In contrast, neurological complications and 30-, 60-, and 90-day readmissions did not differ significantly across quartiles.

SDI quartile was associated with comorbidity burden, ASA class, skull base tumor location, operative time, and risk of non-neurological complications after meningioma resection. SDI may serve as a prognostic marker to help identify vulnerable patients, guide perioperative planning, and improve recovery counseling after meningioma resection.