TY - JOUR
T1 - Surgical risk factors for post-operative pneumonia following meningioma resection
AU - Oh, Taemin
AU - Safaee, Michael
AU - Sun, Matthew Z.
AU - Garcia, Roxanna M.
AU - McDermott, Michael W.
AU - Parsa, Andrew T.
AU - Bloch, Orin
N1 - Funding Information:
The authors have no financial interests to report. This work was supported by the Reza and Georgianna Khatib Endowed Chair in Skull Base Tumor Surgery at UCSF, and the Khatib Endowed Professorship at Northwestern University.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2014/3
Y1 - 2014/3
N2 - 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.
AB - 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.
KW - Complications
KW - Meningioma
KW - Morbidity
KW - Pneumonia
KW - Surgery
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U2 - 10.1016/j.clineuro.2013.12.017
DO - 10.1016/j.clineuro.2013.12.017
M3 - Article
C2 - 24529234
AN - SCOPUS:84893085322
VL - 118
SP - 76
EP - 79
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
SN - 0303-8467
ER -