Dickinson Holly, Carico Christine, Nuño Miriam, Nosova Kristin, Elramsisy Adam, Patil Chirag G
Department of Neurosurgery, Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute, Cedars-Sinai Medical Center 8631 W. Third Street, Suite 800E, Los Angeles, CA 90048, USA.
Surg Neurol Int. 2013 Apr 3;4:45. doi: 10.4103/2152-7806.110023. Print 2013.
Meningiomas are more prevalent in women and mostly benign in nature. Our aim was to evaluate the association of weight and outcomes of meningioma patients undergoing craniotomy.
A retrospective analysis of meningioma patients discharged postcraniotomy between 1998 and 2007 was conducted. Univariate and multivariate analysis evaluated in-hospital mortality, complications, length of stay (LOS), and cost.
According to the nationwide inpatient sample (NIS) database, an estimated 72,257 adult meningioma patients underwent a craniotomy in US hospitals during the study period. Female and male weight loss rates were 0.7% and 1.2%, respectively; obesity rates were 5.2% and 3.7%. Males had higher rates of malignant tumors than females (6.2% vs. 3.5%, P < 0.0001), and malignant tumors were more common in patients with weight loss (6.4% vs. 4.3%, P = 0.03). Weight loss was associated with higher mortality in men (OR 6.66, P < 0.0001) and women (OR 3.92, P = 0.04) as well as higher rates of postoperative complications in both men (OR 6.13, P < 0.0001) and women (OR 8.37, P < 0.0001). Furthermore, patients suffering weight loss had longer LOS and higher overall hospital cost when compared with all patients. In contrast, obesity seemed to reduce mortality (OR 0.47, P = 0.0006) and complications (OR 0.8, P = 0.0007) among women.
In summary, weight loss seems to be the single most critical factor present in patients experiencing higher mortality, complications, hospital charges, and longer LOS. However, further studies aimed to assess the inter-relation of potential preexisting comorbidities and weight loss are needed to establish causation.
脑膜瘤在女性中更为常见,且大多为良性。我们的目的是评估体重与接受开颅手术的脑膜瘤患者预后之间的关联。
对1998年至2007年间开颅手术后出院的脑膜瘤患者进行回顾性分析。单因素和多因素分析评估了住院死亡率、并发症、住院时间(LOS)和费用。
根据全国住院患者样本(NIS)数据库,在研究期间,估计有72257名成年脑膜瘤患者在美国医院接受了开颅手术。女性和男性的体重减轻率分别为0.7%和1.2%;肥胖率分别为5.2%和3.7%。男性的恶性肿瘤发生率高于女性(6.2%对3.5%,P<0.0001),且体重减轻的患者中恶性肿瘤更为常见(6.4%对4.3%,P=0.03)。体重减轻与男性(OR 6.66,P<0.0001)和女性(OR 3.92,P=0.04)的较高死亡率以及男性(OR 6.13,P<0.0001)和女性(OR 8.37,P<0.0001)的较高术后并发症发生率相关。此外,与所有患者相比,体重减轻的患者住院时间更长,总体住院费用更高。相比之下,肥胖似乎可降低女性的死亡率(OR 0.47,P=0.0006)和并发症发生率(OR 0.8,P=0.0007)。
总之,体重减轻似乎是死亡率较高、并发症较多、住院费用较高和住院时间较长的患者中最关键的单一因素。然而,需要进一步研究以评估潜在的并存疾病与体重减轻之间的相互关系,以确定因果关系。