Early postoperative complications of intracranial tumors in children.
BACKGROUND
The aim of this study was to describe the complications experienced by patients after central nervous system tumor resection during pediatric intensive care Unit (PICU) admission. Our attempt was to assess the association between epidemiological, clinical data and tumor characteristics prior to surgery and presence of postoperative complications.


METHODS
We design an observational, descriptive and retrospective study by review of medical records. Patients aged 0-18 years, admitted to the PICU of our hospital, after surgery for tumor resection in the central nervous system.


RESULTS
We collected a total of 145 postoperative. At PICU, 48.3% of the patients (70/145) had some type of postoperative complication. It they were, in order of frequency: a new neurological deficit at discharge (29%, 42/145), pneumocephalus (21%, 30/145), electrolyte disturbances (17.9%, 26), infection (16.6%, 24), anemia (8.3%, 12), seizures (7.6%, 11), endocrine disorders (7.6%, 11), intracranial hypertension (5.5%, 8) and stroke (7, 4.8%). One patient died. There was no difference in overall complication and the tumor site. However, supratentorial tumors had less need for MV (73% vs. 92%, P=0.002, OR 2.7 [1.2-6.1]), shorter duration for MV (11 hours vs. 48 hours, P=0.02), lower frequency of neurological deficit (22% vs. 37%, P=0.004, OR 1.4 [1-2.1]) and cerebrospinal fluid fistula (1% vs. 13%, P=0.004, OR 2.1 [1.6- 2.8]). They were more frequent seizures (13% vs. 2%, P=0.024, OR 1.8 [1.4-2.3]), central diabetes insipidus (17% vs. 0%, P<0.001, OR 4.3 [1.6-11.7]) and endocrine disruption (14% vs. 0%, P=0.001, OR 2 [1.7-2.4]).


CONCLUSIONS
The intracranial tumors surgery requires monitoring in intensive care because the risk of postoperative complications is high. The tumor location is related to the occurrence of some of these complications.
Pediatric Intensive Care Unit, Niño Jesús University Hospital, Madrid, Spain - Ignacio.mastro@salud.madrid.org.
Ignacio
I
Mastro-Martínez
Pediatric Intensive Care Unit, Niño Jesús University Hospital, Madrid, Spain.
Maria I
MI
Iglesias-Bouzas
Pediatric Intensive Care Unit, Niño Jesús University Hospital, Madrid, Spain.
Beatriz
B
Cabeza Martin
Pediatric Intensive Care Unit, Niño Jesús University Hospital, Madrid, Spain.
Gonzalo
G
Oñoro-Otero
Pediatric Intensive Care Unit, Niño Jesús University Hospital, Madrid, Spain.
Carlos
C
Perez-Diaz
Pediatric Intensive Care Unit, Niño Jesús University Hospital, Madrid, Spain.
Ana
A
Serrano-Gonzalez
Pediatric Intensive Care Unit, Niño Jesús University Hospital, Madrid, Spain.
Juan
J
Casado-Flores
D000293:Adolescent; D001932:Brain Neoplasms / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology* / Q000503:physiopathology; D011184:Postoperative Period; D012189:Retrospective Studies