Abstract
Purpose
This study was performed to assess the effect of baseline Preoperative Laboratory
Values (PLV) on post-operative Brain Tumor Resection (BTR) outcomes in a large national
registry.
Methods
We extracted data from the National Surgical Quality Improvement Program (NSQIP) database
for BTR patients 2015–2019 (n = 3 0,951). Uni- and multivariate analyses were performed
for PLV and key surgical outcomes.
Results
The most significant PLV predictors of 30-day mortality after BTR included hypernatremia
(odds ratio, OR 4.184, 95% CI, 2.384–7.343, p < 0.001), high serum creatinine (OR 2.244, 95% CI 1.502–3.352, p < 0.001), thrombocytopenia (OR 1.997, 95% CI 1.438, 2.772, p < 0.001), and leukocytosis (OR 1.635, 95% CI 1.264, 2.116, p < 0.001). The most significant predictors of Clavien IV complications were increased
INR (OR 2.653, 95% CI 1.444, 4.875, p < 0.01), thrombocytopenia (OR 1.514, 95% CI 1.280, 1.792, p < 0.001), hypoalbuminemia (OR 1.480, 95% CI 1.274, 1.719, p < 0.001), and leukocytosis (OR 1.467, 95% CI 1.306, 1.647, p < 0.001). The most robust predictors of eLOS were increased INR (OR 1.941, 95% CI
1.231, 3.060, p < 0.01) and hypoalbuminemia (OR 1.993, 95% CI 1.823, 2.179, p < 0.001), and those for non-routine discharge included increased INR (OR 1.897, 95%
CI 1.196, 3.008, p < 0.01) and hypernatremia (OR 1.565, 95% CI 1.217, 2.012, p < 0.001).
Conclusions
Several PLV independently predicted worse outcomes in BTR patients. Baseline labs
should be routinely used for the pre-operative risk stratification of these patients.
Keywords
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References
- CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2014-2018.Neuro Oncol. 2021; 23 (iii1-iii105)
- Challenges to curing primary brain tumours.Nat Rev Clin Oncol. 2019; 16: 509-520
- Improving maximal safe brain tumor resection with photoacoustic remote sensing microscopy.Sci Rep. 2020; 1017211
- An extent of resection threshold for newly diagnosed glioblastomas.J Neurosurg. 2011; 115: 3-8
- Frailty is associated with mortality in brain tumor patients.Am J Cancer Res. 2021; 11: 3294-3303
- Predicting postoperative outcomes in brain tumor patients with a 5-factor modified frailty index.Neurosurgery. 2020; 88: 147-154
- The 5-factor modified frailty index: an effective predictor of mortality in brain tumor patients.J Neurosurg. 2020; : 1-9
- Association of preoperative frailty with postoperative delirium after elective brain tumor resection: retrospective analysis of a prospective cohort.Surgery. 2021; 170: 1763-1769
- Frailty as a predictor of neurosurgical outcomes in brain tumor patients.World Neurosurg. 2020; 133: e813-e818
- Association of baseline frailty status and age with postoperative morbidity and mortality following intracranial meningioma resection.J Neuro Oncol. 2021; 155: 45-52
- Predictors of inpatient death and complications among postoperative elderly patients with metastatic brain tumors.Ann Surg Oncol. 2011; 18: 521-528
- Length of hospital stay after craniotomy for tumor: a national surgical quality improvement Program analysis.Neurosurg Focus. 2015; 39: E12
- Thrombocytopenia and craniotomy for tumor: a national surgical quality improvement Program analysis.Cancer. 2016; 122: 1708-1717
- Post-operative complication rate comparison between airway surgery and upper airway stimulation using NSQIP and ADHERE.OTO Open. 2021; 5 (2473974X211051313)
- Local anesthesia as an alternative option in repair of recurrent groin hernias: an outcome study from the American College of Surgeons NSQIP® database.Ann Med Surg (Lond). 2021; 71102925
- Non-routine discharge disposition is associated with post-discharge complications and 30-day readmissions following craniotomy for brain tumor resection.J Neuro Oncol. 2018; 136: 595-604
- Preoperative laboratory testing in patients undergoing elective, low-risk ambulatory surgery.Ann Surg. 2012; 256: 518-528
- Risk factors for postoperative urinary tract infections in patients undergoing total joint arthroplasty.Adv Orthop. 2016; 20167268985
- Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey.Ann Surg. 2004; 240: 205-213
- The Clavien-Dindo classification of surgical complications: five-year experience.Ann Surg. 2009; 250: 187-196
- Platelet transfusion: a clinical practice guideline from the AABB.Ann Intern Med. 2015; 162: 205-213
- Unplanned reoperation after craniotomy for tumor: a national surgical quality improvement Program analysis.Neurosurgery. 2017; 81: 761-771
- Body habitus, serum albumin, and the outcomes after craniotomy for tumor: a National Surgical Quality Improvement Program analysis.J Neurosurg. 2017; 126: 677-689
- Thirty-day outcomes after craniotomy for primary malignant brain tumors: a national surgical quality improvement Program analysis.Neurosurgery. 2018; 83: 1249-1259
- Preoperative anemia increases postoperative morbidity in elective cranial neurosurgery.Surg Neurol Int. 2014; 5: 156
- Impact of preoperative anemia on outcomes in patients undergoing elective cranial surgery.J Neurosurg. 2014; 120: 764-772
- Effect of hypernatremia on outcomes after severe traumatic brain injury: a nationwide inpatient sample analysis.World Neurosurg. 2018; 118: e880-e886
- Morbidity and mortality associated with hypernatremia in patients with severe traumatic brain injury.Neurosurg Focus. 2017; 43: E2
- Preoperative correction of low hemoglobin levels can reduce 1-year all-cause mortality in osteoporotic hip fracture patients: a retrospective observational study.Clin Interv Aging. 2022; 17: 165-173
- The relevance of hyponatraemia to perioperative care of surgical patients.Surgeon. 2015; 13: 163-169
- Perioperative albumin supplementation is associated with decreased risk of complications following microvascular head and neck reconstruction.J Oral Maxillofac Surg. 2021; 79: 2155-2161
- Nutritional predictors of pharyngocutaneous fistula after total laryngectomy: a multivariate analytic study in a single institution.Auris Nasus Larynx. 2022; 49: 454-459
- Short-term outcomes of craniotomy for malignant brain tumors in the elderly.Cancer. 2013; 119: 1058-1064
- The impact of provider volume on mortality after intracranial tumor resection.Neurosurgery. 2003; 52 (discussion -4): 48-53
Article info
Publication history
Published online: January 31, 2023
Accepted:
January 25,
2023
Received in revised form:
January 15,
2023
Received:
February 4,
2022
Identification
Copyright
© 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
