. 2020 Oct 31;12(11):3209.

doi: 10.3390/cancers12113209.

Comorbidity Burden and Presence of Multiple Intracranial Lesions Are Associated with Adverse Events after Surgical Treatment of Patients with Brain Metastases

Matthias Schneider¹, Muriel Heimann¹, Christina Schaub², Lars Eichhorn³, Anna-Laura Potthoff¹, Frank A Giordano⁴, Erdem Güresir¹, Yon-Dschun Ko⁵, Jennifer Landsberg⁶, Felix Lehmann³, Alexander Radbruch⁷, Katjana S Schwab⁸, Leonie Weinhold⁹, Johannes Weller², Christian Wispel¹, Ulrich Herrlinger², Hartmut Vatter¹, Niklas Schäfer², Patrick Schuss¹

Affiliations

¹ Department of Neurosurgery, Center of Integrated Oncology (CIO) Bonn, University Hospital Bonn, 53127 Bonn, Germany.
² Division of Clinical Neuro-Oncology, Department of Neurology, Center of Integrated Oncology (CIO) Bonn, University Hospital Bonn, 53127 Bonn, Germany.
³ Department of Anesthesiology and Intensive Care, University Hospital Bonn, 53127 Bonn, Germany.
⁴ Department of Radiation Oncology, Center of Integrated Oncology (CIO) Bonn, University Hospital Bonn, 53127 Bonn, Germany.
⁵ Department of Oncology and Hematology, Center of Integrated Oncology (CIO) Bonn, Johanniter Hospital Bonn, 53113 Bonn, Germany.
⁶ Department of Dermatology and Allergy, Center of Integrated Oncology (CIO) Bonn, University Hospital Bonn, 53127 Bonn, Germany.
⁷ Department of Neuroradiology, University Hospital Bonn, 53127 Bonn, Germany.
⁸ Department of Internal Medicine III, Center of Integrated Oncology (CIO) Bonn, University Hospital Bonn, 53127 Bonn, Germany.
⁹ Institute of Medical Biometrics, Informatics, and Epidemiology, University Hospital Bonn, 53127 Bonn, Germany.

PMID: 33142701
PMCID: PMC7692304
DOI: 10.3390/cancers12113209

Comorbidity Burden and Presence of Multiple Intracranial Lesions Are Associated with Adverse Events after Surgical Treatment of Patients with Brain Metastases

Matthias Schneider et al. Cancers (Basel). 2020.

. 2020 Oct 31;12(11):3209.

doi: 10.3390/cancers12113209.

Authors

Affiliations

¹ Department of Neurosurgery, Center of Integrated Oncology (CIO) Bonn, University Hospital Bonn, 53127 Bonn, Germany.
² Division of Clinical Neuro-Oncology, Department of Neurology, Center of Integrated Oncology (CIO) Bonn, University Hospital Bonn, 53127 Bonn, Germany.
³ Department of Anesthesiology and Intensive Care, University Hospital Bonn, 53127 Bonn, Germany.
⁴ Department of Radiation Oncology, Center of Integrated Oncology (CIO) Bonn, University Hospital Bonn, 53127 Bonn, Germany.
⁵ Department of Oncology and Hematology, Center of Integrated Oncology (CIO) Bonn, Johanniter Hospital Bonn, 53113 Bonn, Germany.
⁶ Department of Dermatology and Allergy, Center of Integrated Oncology (CIO) Bonn, University Hospital Bonn, 53127 Bonn, Germany.
⁷ Department of Neuroradiology, University Hospital Bonn, 53127 Bonn, Germany.
⁸ Department of Internal Medicine III, Center of Integrated Oncology (CIO) Bonn, University Hospital Bonn, 53127 Bonn, Germany.
⁹ Institute of Medical Biometrics, Informatics, and Epidemiology, University Hospital Bonn, 53127 Bonn, Germany.

PMID: 33142701
PMCID: PMC7692304
DOI: 10.3390/cancers12113209

Abstract

Surgical resection is a key treatment modality for brain metastasis (BM). However, peri- and postoperative adverse events (PAEs) might be associated with a detrimental impact on postoperative outcome. We retrospectively analyzed our institutional database with regard to patient safety indicators (PSIs), hospital-acquired conditions (HACs) and specific cranial surgery-related complications (CSCs) as high-quality metric profiles for PAEs in patients who had undergone surgery for BM in our department between 2013 and 2018. The comorbidity burden was assessed by means of the Charlson comorbidity index (CCI). A multivariate analysis was performed to identify independent predictors for the development of PAEs after surgical resection of BM. In total, 33 patients (8.5%) suffered from PAEs after surgery for BM. Of those, 17 PSI, 5 HAC and 11 CSC events were identified. Multiple brain metastases (p = 0.02) and a higher comorbidity burden (CCI > 10; p = 0.003) were associated with PAEs. In-hospital mortality of patients suffering from a PAE was significantly higher than that of patients without a PAE (24% vs. 0.6%; p < 0.0001). Awareness of risk factors for postoperative complications enables future prevention and optimal response, particularly in vulnerable oncological patients. The present study identified the presence of multiple brain metastases and increased comorbidity burden associated with PAEs in patients suffering from BM.

Keywords: Charlson comorbidity index; brain metastases; cancer; surgical management.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Kaplan–Meier curves for overall survival (OS) dependent on the occurrence of postoperative adverse events (PAEs).

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Comorbidity Burden and Presence of Multiple Intracranial Lesions Are Associated with Adverse Events after Surgical Treatment of Patients with Brain Metastases

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Comorbidity Burden and Presence of Multiple Intracranial Lesions Are Associated with Adverse Events after Surgical Treatment of Patients with Brain Metastases

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