Emergency glioma resection but not hours of operation predicts perioperative complications: A single center study.
作者信息
Deng Zhong, Wu Wei, Wang Ning, Arafat Wahap, Li Zhijin, Wang Jia, Ren Chunying, Li Rihui, Wang Tuo, Du Changwang, Wang Maode
机构信息
Department of Neurosurgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China; School of medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
Department of Neurosurgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
出版信息
Clin Neurol Neurosurg. 2019 Jul;182:11-16. doi: 10.1016/j.clineuro.2019.04.010. Epub 2019 Apr 13.
OBJECTIVE
Physical and mental status of neurosurgeons may vary with emergency status and hours of operation, which may impact the outcome of patients undergoing surgery. This study aims to clarify the influence of these parameters on outcome after surgery in glioma patients.
PATIENTS AND METHODS
A total of 477 nonemergency surgery (NES) and 30 emergency surgery (ES) were enrolled in this study. Using propensity score matching (PSM) analysis, 97 pairs of procedures from NES group were generated and then classified as group M (morning procedures, 8:00 a.m-1:00 p.m) or group A (afternoon or night procedures, 1:00 p.m-8:00 p.m). 30 emergency procedures were classified into group ESa (daytime emergency surgery, 8:00 a.m-6:00 p.m) and group ESb (nighttime surgery procedures, 6:00 p.m-8:00 a.m the next day). Differences in intraoperative risk factors and postoperative complications were analyzed.
RESULTS
Postoperative complications, including death within 30 days (p = 0.004), neurological function deficit (p = 0.012), systemic infection (p < 0.001) were significant higher in emergency procedures. Intraoperative risk factors including blood loss (p < 0.001), blood transfusion (p = 0.036) were also higher in emergency procedures than nonemergency procedures, although both procedures had comparable time duration (p = 0.337). By PSM analysis, patients in group M and group A were well matched and no significant difference of intraoperative risk factors and postoperative complications (all p > 0.05) were found. Furthermore, incidence of intraoperative risk factors and postoperative complications were similar in both groups ESa and ESb (all p > 0.05).
CONCLUSION
Emergency glioma resection is a very important risk factors of perioperative mortality and morbidity for patients. However, hours of operation did not necessarily predict postoperative mortality or morbidity, either in emergency or nonemergency glioma resection.
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