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. 2016 Aug;77(4):350-7.
doi: 10.1055/s-0036-1572508. Epub 2016 Feb 13.

Increased Operative Time for Benign Cranial Nerve Tumor Resection Correlates with Increased Morbidity Postoperatively

Meghan Murphy  1 , Hannah Gilder  1 , Brandon A McCutcheon  1 , Panagiotis Kerezoudis  1 , Lorenzo Rinaldo  1 , Daniel Shepherd  1 , Patrick Maloney  1 , Kendall Snyder  1 , Matthew L Carlson  2 , Bob S Carter  3 , Mohamad Bydon  1 , Jamie J Van Gompel  1 , Michael J Link  1
Affiliations

Increased Operative Time for Benign Cranial Nerve Tumor Resection Correlates with Increased Morbidity Postoperatively

Meghan Murphy et al. J Neurol Surg B Skull Base. 2016 Aug.

Abstract

Objectives: Operative time, previously identified as a risk factor for postoperative morbidity, is examined in patients undergoing benign cranial nerve tumor resection.

Design/setting/participants: This retrospective cohort analysis included patients enrolled in the ACS-NSQIP registry from 2007 through 2013 with a diagnosis of a benign cranial nerve neoplasm.

Main outcome measures: Primary outcomes included postoperative morbidity and mortality. Readmission and reoperation served as secondary outcomes.

Results: A total of 565 patients were identified. Mean (median) operative time was 398 (370) minutes. The 30-day complication, readmission, and return to the operating room rates were 9.9%, 9.9%, and 7.3%, respectively, on unadjusted analyses. CSF leak requiring reoperation or readmission occurred at a rate of 3.1%. On multivariable regression analysis, operations greater than 413 minutes were associated with an increased odds of overall complication (OR 4.26, 95% CI 2.08-8.72), return to the operating room (OR 2.65, 95% CI 1.23-5.67), and increased length of stay(1.6 days, 95% CI 0.94-2.23 days). Each additional minute of operative time was associated with an increased odds of overall complication (OR 1.004, 95% CI 1.002-1.006) and increased length of stay (0.006 days, 95% CI 0.004-0.008).

Conclusion: Increased operative time in patients undergoing surgical resection of a benign cranial nerve neoplasm was associated with an increased rate of complications.

Keywords: acoustic neuroma; complications; national surgical quality improvement program; operative time; skull base; vestibular schwannoma.

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Figures

Fig. 1
Fig. 1
Receiver operator characteristic (ROC) curve utilized to derive the time threshold for dichotomization.
Fig. 2
Fig. 2
Distribution of operative times.
Fig. 3
Fig. 3
Mean composite morbidity across the spectrum of operative times.
See this image and copyright information in PMC

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