Risk factors for the development of serious medical complications after resection of meningiomas. Clinical article.
OBJECTIVE
While the surgical and neurological risks of meningioma surgery have been reported, much less effort has been devoted to studying the rates of serious medical complications following such a procedure. The authors performed a review of 834 patients who underwent craniotomy for meningioma at their institution and analyzed the rate of major cardiac, pulmonary, renal, and hepatic complications.


METHODS
The authors identified all patients between 1993 and 2007 who underwent craniotomy for meningioma. Clinical information was reconstructed using patient medical records, medication records, radiological data, and pathological specimens from both the author institution and outside medical facilities. Stepwise multivariate logistic regression analysis was performed to test the association between the dependent variable (rate of medical complications) and all covariates with a p < 0.2 on univariate testing.


RESULTS
Fifty-seven patients (6.8%) experienced 61 serious medical complications following surgery for meningioma. Four patients died of medical complications. The most common complication was pneumonia, followed by renal dysfunction, arrhythmia, and deep venous thrombosis and/or pulmonary embolus. The development of a new or worsened neurological deficit (p < 0.00001), an age > 65 years (p < 0.03), hypertension (p < 0.02), and being on > 2 cardiac medications prior to surgery (p < 0.004) all demonstrated significantly increased rates of medical complications on univariate analysis. On multivariate analysis, only a new or worsened neurological deficit remained a significant risk factor for the occurrence of serious medical complications (p < 0.00001).


CONCLUSIONS
Overall, the authors found that the rate of clinically detected serious medical complications is relatively low in this population (6.8%), given the duration and complexity of the meningioma operations, and is strongly linked to the subsequent development of significant medical complications. This information may be useful to surgeons in discussing the morbidity of surgery during the informed consent process.
Sughrue
Michael E
ME
Brain Tumor Research Center, Department of Neurological Surgery, University of California, San Francisco, California, USA.
Rutkowski
Martin J
MJ
Shangari
Gopal
G
Chang
H Quinn
HQ
Parsa
Andrew T
AT
Berger
Mitchel S
MS
McDermott
Michael W
MW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003399:Craniotomy; D003627:Data Interpretation, Statistical; D016208:Databases, Factual; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology / Q000209:etiology; D008107:Liver Diseases / Q000453:epidemiology / Q000209:etiology; D008171:Lung Diseases / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000401:mortality; D019990:Perioperative Care; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D011300:Preoperative Care; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult