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Do the indices of deprivation or smoking affect post-operative 1-year mortality in patients undergoing a craniotomy for a brain tumour in a public healthcare system?

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Abstract

Objective

We sought to determine the 1-year survival following craniotomy for tumour resection in a public healthcare system and analyse the effect of indices of multiple deprivation (IMD) as well as smoking, alcohol, BMI, ASA grade and medical co-morbidities on post-operative morbidity and mortality.

Methods

This is a retrospective, single-centre study in a high volume neurosurgical centre, over a 2-year period. All patients undergoing a craniotomy for a brain tumour were included. Data was collected from the neuro-oncology database and electronic patient records. Individual patient IMD data was obtained using their postcode from a national government database. Each English postcode being ranked from 1 to 32,844, with 1 being the most deprived and 32,844 the most affluent. Descriptive results are described along with further data analysis using multiple linear and logistic regression analyses.

Results

630 patients underwent an elective or urgent craniotomy for tumour. 10% of all patients underwent urgent surgery. 68% (95% CI: 64 to 71%) survived at least 1-year post-surgery. Our study found that social deprivation (IMD postcode rank) was not associated with mortality at 1 year after adjusting for potential confounding factors. Those from decile 1 had the lowest risk of death at 12 months for all tumour types (p = 0.0070). Previous smokers carried an increased risk of death at 12 months when compared with people who had never smoked RR 1.40 CI 1.10–1.78 (p = 0.006) but this risk was not evident in current smokers RR 0.92 CI 0.65–1.31 (p = 0.64). Increasing age and male gender were also found to be associated with higher mortality at 1 year (p =  < 0.001).

Conclusions

In the UK despite the discrepancy in the health of the general population between the north and south, social deprivation does not appear to be detrimental to neurooncological outcomes although smoking status, advancing age and male sex are.

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Authors and Affiliations

  1. Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Stott Lane, Manchester, M6 8HD, UK

    Helen Maye, James Balogun, Mueez Waqar, Nathan McSorley, Pietro D’Urso, David Coope, Matthew Bailey & Konstantina Karabatsou

  2. Division of Neurosurgery, Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria

    James Balogun

  3. Centre for Biostatistics, University of Manchester, Manchester, UK

    Calvin Heal

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  1. Helen Maye
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  2. James Balogun
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  4. Calvin Heal
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Correspondence to Helen Maye.

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Maye, H., Balogun, J., Waqar, M. et al. Do the indices of deprivation or smoking affect post-operative 1-year mortality in patients undergoing a craniotomy for a brain tumour in a public healthcare system?. Acta Neurochir 165, 1683–1693 (2023). https://doi.org/10.1007/s00701-023-05582-x

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