title: Case-Control Study of Patients at Risk of Medical Complications after Elective Craniotomy.
abstract: OBJECTIVE
  Medical complications severely impair recovery of neurosurgical patients after craniotomy. The purpose of this study was to identify patients at risk of peri- and postoperative medical complications. Therefore, we present a large population of patients with different medical complications after elective craniotomy.
  
  
  METHODS
  We retrospectively screened all patients who had been consecutively treated at our department between June 2009 and June 2014. Patients with any postoperative thromboembolic complication or pulmonary or systemic infection were compared with a control group without any medical complication. Peri- and postoperative complications were statistically analyzed with regard to their association with age, sex, comorbidity, indication for craniotomy, duration of surgery, surgical position, type of anesthesia, and previous craniotomy by means of logistic regression models.
  
  
  RESULTS
  Of 1800 patients screened, 133 patients (67 women and 66 men aged between 14 and 85 years) had developed medical complications (overall morbidity, 7.4%). We found statistically significant correlations between thromboembolic events and meningioma, previous craniotomy, duration of surgery, and hypertension (P = 0.002, P = 0.032, P < 0.001, and P < 0.001, respectively). Severe infection was associated with age, duration of surgery, and craniopharyngioma and pituitary adenoma (P = 0.012, P = 0.004, and P = 0.029, respectively). Prolonged stay in the intensive care unit was associated with increased duration of surgery and hypertension (P = 0.002 and P < 0.001).
  
  
  CONCLUSIONS
  In this study, we identified predictors that help characterize patients at risk of medical complications after elective neurosurgical procedures. These correlations should be taken into account when advising patients on craniotomy.
authors.affiliation: Department of Neurosurgery, University Medical Center Regensburg, Regensburg, Bavaria, Germany. Electronic address: Judith.Anthofer@klinik.uni-regensburg.de.
authors.forename: Judith
authors.initials: J
authors.lastname: Anthofer
authors.affiliation: Department of Neurosurgery, University Medical Center Regensburg, Regensburg, Bavaria, Germany.
authors.forename: Megan
authors.initials: M
authors.lastname: Wester
authors.affiliation: Center for Clinical Studies, University Medical Center Regensburg, Regensburg, Bavaria, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Zeman
authors.affiliation: Department of Neurosurgery, University Medical Center Regensburg, Regensburg, Bavaria, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Brawanski
authors.affiliation: Department of Neurosurgery, University Medical Center Regensburg, Regensburg, Bavaria, Germany.
authors.forename: Karl-Michael
authors.initials: KM
authors.lastname: Schebesch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003399:Craniotomy / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D055815:Young Adult
keywords: Complication; Craniotomy; High-risk patients; Postoperative ICU stay; Postoperative medical complication