title: Surgical mortality at 30 days and complications leading to recraniotomy in 2630 consecutive craniotomies for intracranial tumors.
abstract: BACKGROUND
  In order to weigh the risks of surgery against the presumed advantages, it is important to have specific knowledge about complication rates.
  
  
  OBJECTIVE
  To study the surgical mortality and rate of reoperations for hematomas and infections after intracranial surgery for brain tumors in a large, contemporary, single-institution consecutive series.
  
  
  METHODS
  All adult patients from a well-defined population of 2.7 million inhabitants who underwent craniotomies for intracranial tumors at Oslo University Hospital from 2003 to 2008 were included (n = 2630). The patients were identified from our prospectively collected database and their charts studied retrospectively. Follow-up was 100%.
  
  
  RESULTS
  The overall surgical mortality, defined as death within 30 days of surgery, was 2.3% (n = 60). The mortality rates for high- and low-grade gliomas, meningiomas, and metastases were 2.9%, 1.0%, 0.9%, and 4.5%, respectively. Age >60 (odds ratio 1.84, P < 0.05) and biopsy compared with resection (odds ratio 4.67, P < 0.01) were significantly positively associated with increased surgical mortality. Hematomas accounted for 35% of the surgical mortality. Postoperative hematomas needing evacuation occurred in 2.1% (n = 54). Age >60 was significantly correlated to increased risk of postoperative hematomas (odds ratio 2.43, P < 0.001). A total of 39 patients (1.5%) were reoperated for postoperative infection. Meningiomas had an increased risk of infections compared with high-grade gliomas (odds ratio 4.61, P < 0.001).
  
  
  CONCLUSIONS
  The surgical mortality within 30 days of surgery was 2.3%, with age >60 and biopsy vs resection being the 2 factors significantly associated with increased mortality. Postoperative hematomas caused about one third of the surgical mortality.
authors.affiliation: Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Lassen
authors.forename: Eirik
authors.initials: E
authors.lastname: Helseth
authors.forename: Pål
authors.initials: P
authors.lastname: Rønning
authors.forename: David
authors.initials: D
authors.lastname: Scheie
authors.forename: Tom Børge
authors.initials: TB
authors.lastname: Johannesen
authors.forename: Jan
authors.initials: J
authors.lastname: Mæhlen
authors.forename: Iver A
authors.initials: IA
authors.lastname: Langmoen
authors.forename: Torstein R
authors.initials: TR
authors.lastname: Meling
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality* / Q000601:surgery*; D003399:Craniotomy / Q000009:adverse effects* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality*; D011446:Prospective Studies; D012042:Registries; D012086:Reoperation / Q000401:mortality; D012189:Retrospective Studies; D055815:Young Adult