Log in |
Rachel Grossman MD, Debraj Mukherjee MD, David C. Chang PhD, Michael Purtell MD, Michael Lim MD, Henry Brem MD, Alfredo Quiñones-Hinojosa MD
View full article HTML | View full article PDF | Download Citation
Risks of brain surgery in elderly patients with brain metastases are not well defined. This study was designed to quantify the postoperative risk for these patients after brain surgery for metastatic disease to the brain.
We performed a retrospective analysis of the Nationwide Inpatient Sample (1998–2005). Patients aged 65 years or older who underwent tumor resection of brain metastases were identified by ICD-9 coding. Primary outcome was inpatient death. Other outcomes included systemic postoperative complications, length of stay (LOS), and total charges.
A total of 4,907 patients (53.6% men) were identified. Mean age was 72.1 years. Mean Charlson comorbidity score was 7.8. Inpatient mortality was 4%. The most common adverse events were pulmonary complications (3.4%). Mean length of stay was 9.2 days. Mean total charges were $57,596.39.
In multivariate analysis, patients up to age 80 years had no significantly greater odds of inpatient death, relative to their 65- to 69-year-old counterparts. Each 1-point increase in Charlson score was associated with 12% increased odds of death, 0.52 days increased LOS, and $1,710.61 higher hospital charges. Postoperative pulmonary complications, stroke, or thromboembolic events increased LOS and total charges by up to 9.6 days and $57,664.42, respectively. These associations were statistically significant (P < 0.05).
Surgical resection of brain metastases among the elderly up to the ninth decade of life is feasible. Age older than 80 years and higher Charlson comorbidity scores were found to be important prognostic factors for inpatient outcome. Incorporating these factors into preoperative decision making may help to select appropriately those elderly candidates for neurosurgical intervention.
Go to Issue Contents
Add this article to your Personal Archive
Effective January 2013, there will be a processing fee of $50 USD for each initial new submission of an Annals article, excluding editorials. Submitted new manuscripts will not enter the review process until the submission fee has been paid. . There will be no processing fee associated with resubmitted manuscripts.
HIGHLIGHTED VIDEO OF THE MONTH
Lymphatic Mapping and Sentinel Node Biopsy in the Colonic Mesentery by Natural Orifice Transluminal Endoscopic Surgery (NOTES) by R. A. Cahill MD, FRCS, S. Perretta MD, J. Leroy MD, B. Dallemagne MD, and J. Marescaux MD, FRCS, FACS. Annals of Surgical Oncology. Volume 15, Number 10, DOI: 10.1245/s10434-008-9952-8
Annals of Surgical Oncology is copyrighted by the Society of Surgical Oncology
© Springer Healthcare Ltd. A part of Springer Science+Business Media