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Impact of operative length on post-operative complications in meningioma surgery: a NSQIP analysis

Journal of Neuro-Oncology volume 131, pages 59–67 (2017)Cite this article

Abstract

Many studies have implicated operative length as a predictor of post-operative complications, including venous thromboembolism [deep vein thrombosis (DVT) and pulmonary embolism (PE)]. We analyzed the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database from 2006 to 2014, to evaluate whether length of operation had a statistically significant effect on post-operative complications in patients undergoing surgical resection of meningioma. Patients were included for this study if they had a post-operative diagnosis of meningioma. Patient demographics, pre-operative comorbidities, and post-operative 30-day complications were analyzed. Of 3743 patients undergoing craniotomy for meningioma, 13.6 % experienced any complication. The most common complications and their median time to occurrence were urinary tract infection (2.6 %) at 10 days postoperatively (IQR 7–15), unplanned intubation (2.5 %) at 3 days (IQR 1–7), failure to wean from ventilator (2.4 %) at 2.0 days (IQR 2–4), and DVT (2.4 %) at 6 days (IQR 11–19). Postoperatively, 3.6 % developed VTE; 2.4 % developed DVT and 1.7 % developed PE. Multivariable analysis identified older age (third and upper quartile), obesity, preoperative ventilator dependence, preoperative steroid use, anemia, and longer operative time as significant risk factors for VTE. Separate multivariable logistic regression models demonstrated longer operative time as a significant risk factor for VTE, all complications, major complications, and minor complications. Meningioma resection is associated with various post-operative complications that increase patient morbidity and mortality risk. this large, multi-institutional patient sample, longer operative length was associated with increased risk for postoperative venous thromboembolisms, as well as major and minor complications.

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Funding

This study was not supported by funding from any extramural resources.

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Affiliations

  1. Department of Neurosurgery, Cushing Neurosurgery Outcomes Center, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA

    Aditya V. Karhade, Luis Fandino, Saksham Gupta, David J. Cote, Julian B. Iorgulescu, Ian F. Dunn & Timothy R. Smith

  2. Department of Neurosurgery, University Medical Center, Utrecht, The Netherlands

    Marike L. Broekman

  3. Department of Anesthesiology, Perioperative, and Pain Medicine, Cushing Neurosurgery Outcomes Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Linda S. Aglio

Authors
  1. Aditya V. Karhade
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  2. Luis Fandino
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  3. Saksham Gupta
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  4. David J. Cote
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  5. Julian B. Iorgulescu
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  7. Linda S. Aglio
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  8. Ian F. Dunn
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  9. Timothy R. Smith
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Corresponding author

Correspondence to Timothy R. Smith.

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The authors declare that they have no conflict of interest.

Disclosures

The authors have nothing to disclose. The American College of Surgeons National Surgical Quality Improvement Program and the hospitals participating in the ACS NSQIP are the source of the data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors.

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Karhade, A.V., Fandino, L., Gupta, S. et al. Impact of operative length on post-operative complications in meningioma surgery: a NSQIP analysis. J Neurooncol 131, 59–67 (2017). https://doi.org/10.1007/s11060-016-2262-2

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  • DOI: https://doi.org/10.1007/s11060-016-2262-2

Keywords

  • Meningioma
  • Operation length
  • Complications
  • Neurosurgery
  • Outcomes
  • Surgical outcomes research
  • NSQIP