title: Risk factors for postoperative systemic complications in elderly patients with brain tumors. Clinical article.
abstract: OBJECTIVE
  In elderly patients with brain tumors, the prevention of postoperative systemic complications is extremely important, and identification of the risk factors would be useful for planning therapy. The authors investigated ways to avoid postoperative complications by identifying risk factors.
  
  
  METHODS
  The study population included 84 patients, 70 years of age or older, who underwent surgical brain tumor removal. The following independent factors were assessed by univariate and multivariate analyses: sex, age, preoperative underlying diseases and complications, histopathological findings, preoperative Karnofsky Performance Scale (KPS) score, preoperative whole blood hemoglobin (Hb) level, preoperative serum total protein (TP) level, operation time, intraoperative blood loss, change in Hb level (difference between pre- and postoperative values), and change in TP level (difference between pre- and postoperative values). The cutoff values for significant independent factors were also determined.
  
  
  RESULTS
  Overall, 35 (41.7%) of the 84 patients had a total of 56 postoperative systemic complications. Univariate analysis identified the preoperative KPS score, intraoperative blood loss, change in Hb level, and change in TP level as risk factors for postoperative complications, and multivariate analysis extracted the following risk factors: the preoperative KPS score (p = 0.0450, OR 4.020), intraoperative blood loss (p = 0.0104, OR 6.571), and change in Hb levels (p = 0.0023, OR 9.301). The cutoff values were: KPS score < 80%, intraoperative blood loss >or= 350 ml, and change in Hb level >or= 2.0 g/dl.
  
  
  CONCLUSIONS
  In elderly patients with brain tumors, low preoperative KPS score, high intraoperative blood loss, and a large difference between pre- and postoperative Hb levels are significant risk factors for postoperative systemic complications.
authors.affiliation: Department of Neurosurgery, Hirosaki University Graduate School of Medicine, Aomori, Japan. asanoken@cc.hirosaki-u.ac.jp
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Asano
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakano
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Takeda
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ohkuma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D001798:Blood Proteins / Q000032:analysis; D001932:Brain Neoplasms / Q000601:surgery*; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors
chemical_list: D001798:Blood Proteins; D006454:Hemoglobins