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Acta Neurochirurgica

, Volume 157, Issue 2, pp 235–240 | Cite as

Is duration of surgery a risk factor for extracranial complications and surgical site infections after intracranial tumor operations?

  • Arthur GolebiowskiEmail author
  • Christina Drewes
  • Sasha Gulati
  • Asgeir Store Jakola
  • Ole Solheim
Clinical Article - Brain Tumors

Abstract

Background

Duration of surgery has not been much explored as a possible risk factor for complications in neurosurgery.

Objective

To explore the possible impact of duration of surgery on the risk of developing extracranial complications and surgical site infections following intracranial tumor surgery.

Methods

Retrospective review of 1,000 consecutive patients who underwent planned surgery for intracranial tumors at a single institution. Complications within 30 days of surgery were registered.

Results

Of all patients, 18.6 % acquired extracranial complications, and they were seen in 14.3, 17.7, 22.1 and 37.4 % after operations lasting <2, 2–4, 4–6 and ≥6 h (p = 0.025). In multivariate analyses, duration of surgery per hour [OR 1.14 (1.04–1.25)], ASA 3–4 [OR 1.37 (1.14–1.63)] and acquired neurological deficits [OR 1.47 (1.02–2.11)] were associated with extracranial complications. For surgical site infections, there was a significant association between increased risk and increased duration of surgery (p < 0.001).

Conclusion

Duration of surgery together with comorbidity and acquired neurological deficits is an independent risk factor for extracranial complications after brain tumor surgery. Duration of surgery is also associated with surgical site infections. Knowledge about the potential harm of slow surgery should be of interest to neurosurgeons when deciding on various surgical approaches, surgical tools or providing training. Also if acquiring ethical approval or informed consent in technical research projects, the risks associated with prolonging brain surgery should be considered. Special consideration should be warranted in patients with significant comorbidity, planned long surgery and higher risk of acquiring neurological deficits after surgery.

Keywords

Brain tumor Neurosurgery Operative time Postoperative complications 

Abbreviations

ASA

American Society of Anesthesiologists

CCI

Charlson Comorbidity Index

CNS

Central nervous system

CSF

Cerebrospinal fluid

DVT

Deep vein thrombosis

ICU

Intensive care unit

LWMH

Low-weight molecular heparin

OR

Operating room/odds ratio

PE

Pulmonary embolism

SCD

Sequential gradient pneumatic leg compression

SSI

Surgical site infection

UTI

Urinary tract infection

Notes

Acknowledgments

We would like to thank research assistants Lisa Millgård Sagberg and Lina Mohrsen Nordtvedt for helping with data extraction from medical records.

Conflicts of interest

None.

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Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Arthur Golebiowski
    • 1
    Email author
  • Christina Drewes
    • 2
    • 3
  • Sasha Gulati
    • 4
  • Asgeir Store Jakola
    • 4
    • 5
  • Ole Solheim
    • 4
    • 5
    • 6
  1. 1.Faculty of MedicineNorwegian University of Science and TechnologyTrondheimNorway
  2. 2.Department of AnesthesiaSt. Olav’s University HospitalTrondheimNorway
  3. 3.Institute of Circulation and Medical ImagingNorwegian University of Science and TechnologyTrondheimNorway
  4. 4.Department of NeurosurgerySt. Olav’s University HospitalTrondheimNorway
  5. 5.National Competence Centre for Ultrasound and Image-guided TherapySt. Olav’s University HospitalTrondheimNorway
  6. 6.Department of NeuroscienceNorwegian University of Science and TechnologyTrondheimNorway

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