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. 2016 Jan:140:6-10.
doi: 10.1016/j.clineuro.2015.11.005. Epub 2015 Nov 12.

Surgical complications following malignant brain tumor surgery: An analysis of 2002-2011 data

Rafael De la Garza-Ramos  1 , Panagiotis Kerezoudis  2 , Rafael J Tamargo  1 , Henry Brem  1 , Judy Huang  1 , Mohamad Bydon  3
Affiliations

Surgical complications following malignant brain tumor surgery: An analysis of 2002-2011 data

Rafael De la Garza-Ramos et al. Clin Neurol Neurosurg. 2016 Jan.

Abstract

Objectives: To estimate the incidence of surgical complications and associated in-hospital morbidity and mortality following surgery for malignant brain tumors.

Patients and methods: The Nationwide Inpatient Sample (NIS) database was queried from 2002 to 2011. All adult patients who underwent elective brain surgery for a malignant brain tumor were included. Surgical complications included wrong side surgery, retention of a foreign object, iatrogenic stroke, meningitis, hemorrhage/hematoma complicating a procedure, and neurological complications. A regression model was conducted to estimate the odds ratios (OR) with their 95% confidence intervals (95% CI) of in-hospital mortality for each surgical complication.

Results: A total of 16,530 admissions were analyzed, with 601 (36.2 events per 1000 cases) surgical complications occurring in 567 patients. Over the examined 10-year period, the overall incidence of surgical complications did not change (P=0.061) except for iatrogenic strokes, which increased in incidence from 14.1 to 19.8 events per 1000 between 2002 and 2011 (P=0.023). Patients who developed a surgical complication had significantly longer lengths of stay, total hospital costs, and higher rates of other complications. Patients who experienced an iatrogenic stroke had a significantly increased risk of mortality (OR 9.6; 95% 6.3-14.8) and so were patients with a hemorrhage/hematoma (OR 3.3; 95% CI 1.6-6.6).

Conclusion: In this study of an administrative database, patients undergoing surgery for a malignant brain tumor who suffered from a surgical complication had significantly longer lengths of stay, total hospital charges, and complication rates. Having a surgical complication was also an independent risk factor for in-hospital mortality. Nonetheless, it is unclear whether all surgical complications were clinically relevant, and further research is encouraged.

Keywords: Malignant brain tumor; Nationwide inpatient sample; Neurosurgery; Sentinel event; Surgical complication.

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Conflict of interest statement

Competing interests disclosures

None.

Figures

Fig. 1
Fig. 1
Framework for patient selection shows inclusion/exclusion criteria.
Fig. 2
Fig. 2
Average length of stay for patients undergoing malignant brain tumor surgery between 2002 and 2011. Length of stay significantly decreased over time (P < 0.001).
Fig. 3
Fig. 3
Mean total hospital charges for patients undergoing malignant brain tumor surgery between 2002 and 2011. Hospital charges increased significantly over time (P < 0.001).
See this image and copyright information in PMC

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