title: Predictors of severe complications in intracranial meningioma surgery: a population-based multicenter study.
abstract: OBJECTIVE
  To investigate predictors of complications after intracranial meningioma resection using a standardized reporting system for adverse events.
  
  
  METHODS
  A retrospective review was conducted in a Scandinavian population-based cohort of 979 adult operations for intracranial meningioma performed at 3 neurosurgical centers with population-based referral between January 1, 2007, and June 30, 2013. Possible predictors of severe complications were identified and analyzed in univariable analyses. Variables with a P value < 0.10 were included in a multivariable model.
  
  
  RESULTS
  Severe complications were observed in 68 (7%) operations. Univariable analyses identified patient age >70 years (P < 0.001), male sex (P = 0.03), Charlson Comorbidity Index >1 (P = 0.02), Simpson grade >3 (P = 0.03), Karnofsky performance scale score <70 (P < 0.001), and duration of surgery >4 hours (P < 0.001) as significant predictors of severe complications. Age >70 (odds ratio = 2.5, P < 0.01), duration of surgery >4 hours (odds ratio = 3.2, P < 0.001), and Karnofsky performance scale score <70 (odds ratio = 2.5, P < 0.01) were independent predictors of severe complications in the multivariable regression analysis.
  
  
  CONCLUSIONS
  Severe complications after meningioma resection are more encountered often in elderly patients (>70 years old), dependent patients (Karnofsky performance scale score <70), and patients who underwent longer lasting surgery (>4 hours). Patient selection, including careful consideration of the individual risk-benefit ratio, is important in improving the safety of intracranial meningioma resection.
authors: Department of Clinical Neuroscience, Section for Neurosurgery, Karolinska Institutet, Stockholm, Sweden; Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. Electronic address: jiri.bartek@karolinska.se.
authors: Jiri
authors: J
authors: Bartek
authors: Department of Neurosurgery, University Hospital of North Norway, Tromsø, Norway.
authors: Kristin
authors: K
authors: Sjåvik
authors: Department of Clinical Neuroscience, Section for Neurosurgery, Karolinska Institutet, Stockholm, Sweden; Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
authors: Petter
authors: P
authors: Förander
authors: Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; Norwegian Advisory Unit for Ultrasound and Image-Guided Surgery, Trondheim, Norway.
authors: Ole
authors: O
authors: Solheim
authors: Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; Norwegian Centre of Competence in Deep Brain Stimulation for Movement Disorders, St. Olavs University Hospital, Trondheim, Norway.
authors: Sasha
authors: S
authors: Gulati
authors: Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; National Advisory Unit on Spinal Surgery, St. Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
authors: Clemens
authors: C
authors: Weber
authors: Department of Neurosurgery, University Hospital of North Norway, Tromsø, Norway.
authors: Tor
authors: T
authors: Ingebrigtsen
authors: Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; Norwegian Advisory Unit for Ultrasound and Image-Guided Surgery, Trondheim, Norway; Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors: Asgeir S
authors: AS
authors: Jakola
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D012737:Sex Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Charlson Comorbidity Index; Complications; Ibanez classification; Karnofsky performance scale; Meningioma; Outcome