|Paper title||The influence of preoperative dependency on mortality, functional recovery and complications after microsurgical resection of intracranial tumors|
|Form of presentation||Poster|
Aim: The decision whether to operate on patients with intracranial tumors is complex and influenced by patient-specific factors, including the preoperative functional status. It was our objective to assess risks for mortality and complications, and post-operative recovery in functionally dependent patients undergoing microsurgical resection of intracranial tumors.
Methods: Observational two-center study, analyzing institutional registry data. Dependency was defined as admission Karnofsky Performance Scale (KPS) of ≤ 50. The primary endpoint was in-hospital mortality. Secondary endpoints were rate and type (Clavien-Dindo grade (CDG)) of complications, as well as postoperative change in KPS until the 3-month follow-up (M3).
Results: Of n=1951 patients, n=98 (5.0%) were dependent. Mortality rates were 2.0% for dependent and 0.4% for independent patients (p=0.018). In univariate analysis, dependent patients were more likely than independent patients to die in hospital (OR 5.49, 95% CI 1.12-26.8, p=0.035). In a multivariate model, the effect was slightly attenuated (OR 4.75, 95% CI 0.91-24.7, p=0.064). Dependent patients tended to experience more postoperative complications. They were more likely to suffer from a severe complication (CDG 4&5; OR 3.55, 95% CI 1.49-8.46, p=0.004). In 40.8% and 52.4% of cases, dependent patients regained functional independence at discharge and M3, respectively.
Conclusions: In operated patients with intracranial tumors presenting functionally dependent at admission, the risk for in-hospital mortality and complications is elevated. However, if conducted successfully, surgery may lead to regain of independence in every second patient within three months.