Connolly Ian D, Cole Tyler, Veeravagu Anand, Popat Rita, Ratliff John, Li Gordon
Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA.
Division of Epidemiology, Department of Health Research and Policy, Stanford University, Stanford, California, USA.
World Neurosurg. 2015 Dec;84(6):1864-70. doi: 10.1016/j.wneu.2015.08.018. Epub 2015 Aug 28.
We sought to describe complications after resection for meningioma with the use of longitudinal administrative data, which our group has shown recently to be superior to nonlongitudinal administrative data.
We identified patients who underwent resection for meningioma between 2010 and 2012 in the Thomson Reuters MarketScan database. Current Procedural Terminology coding at inpatient visit was used to select for meningioma resection procedure. Comorbidities and complications were obtained by use of the International Classification of Diseases, Ninth Revision or Current Procedural Terminology coding. Associations between complications and demographic and clinical factors were evaluated with logistic regression.
We identified a total of 2216 patients. Approximately 41% developed 1 or more perioperative complications. Approximately 15% were readmitted within 30 days of their procedure. The most frequent complications that occurred in our cohort were new postoperative seizures (11.8%), postoperative dysrhythmia (7.9%), intracranial hemorrhage (5.9%), and cerebral artery occlusion (5.4%). General neurosurgical complications and general neurologic complications occurred in 4.4% and 16.1% of patients, respectively. Nearly 55% of elderly patients (≥ 70 years) developed 1 or more perioperative complication (vs. 39% of nonelderly patients). After we adjusted for comorbidities, elderly status and male sex were found to be significantly associated with increased odds for a variety of complications.
In this study, we report complication rates in patients undergoing resection for meningioma. Because of the longitudinal nature of the MarketScan database, we were able to capture a wide array of specific postoperative complications associated with meningioma resection procedures. Care should be taken in the selection of candidates for meningioma resection.
我们试图利用纵向管理数据描述脑膜瘤切除术后的并发症情况，我们团队最近已证明这些数据优于非纵向管理数据。
我们在汤森路透市场扫描数据库中确定了2010年至2012年间接受脑膜瘤切除术的患者。使用住院就诊时的当前程序编码来选择脑膜瘤切除手术。通过使用国际疾病分类第九版或当前程序编码来获取合并症和并发症。使用逻辑回归评估并发症与人口统计学和临床因素之间的关联。
我们共确定了2216名患者。约41%的患者出现了1种或更多种围手术期并发症。约15%的患者在手术后30天内再次入院。我们队列中最常见的并发症是术后新发癫痫（11.8%）、术后心律失常（7.9%）、颅内出血（5.9%）和脑动脉闭塞（5.4%）。一般神经外科并发症和一般神经并发症分别发生在4.4%和16.1%的患者中。近55%的老年患者（≥70岁）出现了1种或更多种围手术期并发症（相比之下，非老年患者为39%）。在我们对合并症进行调整后，发现老年状态和男性性别与多种并发症的发生几率增加显著相关。
在本研究中，我们报告了接受脑膜瘤切除术患者的并发症发生率。由于市场扫描数据库的纵向性质，我们能够捕捉到与脑膜瘤切除手术相关的一系列特定术后并发症。在选择脑膜瘤切除手术的候选人时应谨慎。
