title: One-year outcome after neurosurgery for intracranial tumor in elderly patients.
abstract: BACKGROUND
  The number of elderly patients proposed for brain tumor removal is increasing. Only few data on long-term functional prognosis after intracranial surgery are available.
  
  
  METHODS
  Prospective, observational study of all patients greater than 70 year of age operated for intracranial tumors. Two scales for health status evaluation were used: Karnofsky Performance Scale (KPS) and Activities of Daily Living (ADL) score. Data were expressed as medians (first to third quartiles). The primary endpoint was the probability to remain nondependant (ADL>3 and KPS≥70%) after 1 year.
  
  
  RESULTS
  Between 2003 and 2007, 90 patients were included: 46 (51.1%) meningioma, 17 (18.9%) high-grade glioma, and 11 (12.2%) metastasis. At hospital admission, age was 73.50 years (71.25-76.00), American Society of Anesthesiology score 2 (2 to 3), KPS 80% (70-90), ADL 5.5 (4.5 to 6.0). Two patients died during the first 28 days, 3 others during the first year. Both KPS and ADL decreased after 1 year: KPS 80% (70 to 90; mean: 80%) at hospital admission versus 80% (60 to 90) at 1 year (mean: 70%), P=0.003; ADL 5.5 (4.5 to 6.0) at hospital admission versus 5.0 (3.25 to 5.50) at 1 year, P=0.001. In multivariate analysis, 2 preoperative parameters were associated with autonomy at 1 year: the ADL at hospital admission and meningioma as histologic type.
  
  
  CONCLUSIONS
  In this series of elderly patients, intracranial tumor surgery was associated with low 1-year mortality. Meningioma was associated with a better postoperative functional outcome. Preoperative ADL score was a predictive of functional evolution 1 year after the surgery.
authors.affiliation: Department of Anesthesiology, Critical Care and SAMU, Lariboisiére Hospital, Paris, France. romain.pirracchio@lrb.aphp.fr
authors.forename: Romain
authors.initials: R
authors.lastname: Pirracchio
authors.forename: Matthieu
authors.initials: M
authors.lastname: Resche-Rigon
authors.forename: Damien
authors.initials: D
authors.lastname: Bresson
authors.forename: Benedetta
authors.initials: B
authors.lastname: Basta
authors.forename: Stéphane
authors.initials: S
authors.lastname: Welschbillig
authors.forename: Laurent
authors.initials: L
authors.lastname: Heyer
authors.forename: Hakim
authors.initials: H
authors.lastname: Kechiche
authors.forename: Catarina
authors.initials: C
authors.lastname: Madadaki
authors.forename: Alain
authors.initials: A
authors.lastname: Chollet
authors.forename: Anne Claire
authors.initials: AC
authors.lastname: Lukaszewicz
authors.forename: Alexandre
authors.initials: A
authors.lastname: Mebazaa
authors.forename: Bernard
authors.initials: B
authors.lastname: George
authors.forename: Didier
authors.initials: D
authors.lastname: Payen
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005544:Forecasting; D005910:Glioma / Q000601:surgery; D006801:Humans; D057187:Independent Living; D017567:Karnofsky Performance Status; D008137:Longitudinal Studies; D008297:Male; D008579:Meningioma / Q000601:surgery; D009362:Neoplasm Metastasis; D019635:Neurosurgical Procedures; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome