Scharnböck Elisa, Weinhold Leonie, Potthoff Anna-Laura, Schäfer Niklas, Heimann Muriel, Lehmann Felix, Güresir Erdem, Bode Christian, Jacobs Andreas H, Vatter Hartmut, Herrlinger Ulrich, Schneider Matthias, Schuss Patrick
Department of Neurosurgery, Center of Integrated Oncology (CIO) Bonn, University Hospital Bonn, 53127 Bonn, Germany.
Institute of Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital Bonn, 53127 Bonn, Germany.
Cancers (Basel). 2020 Dec 31;13(1):98. doi: 10.3390/cancers13010098.
Indication for surgical treatment in patients with intracranial meningioma must include both clinical aspects and an individual risk-benefit stratification, especially in geriatric patients. Prolonged mechanical ventilation (PMV) has not been investigated for its potential effects in patients with meningioma. We therefore analyzed the impact of PMV on mortality in geriatric patients who had undergone meningioma resection. Between 2009 and 2019, 261 patients aged ≥ 70 years were surgically treated for intracranial meningioma at our institution. PMV was defined as postoperative invasive ventilation of >7 days. Postoperative PMV was present in 17 of 261 geriatric meningioma patients (7%). Twenty-five geriatric patients (10%) died within 1 year after surgery. A scoring system ("ACKT") based on the variables of age, preoperative C-reactive protein (CRP) value, Karnofsky performance scale and tumor size supports prediction of postoperative PMV (sensitivity 73%, specificity 84%). PMV is significantly associated with increased mortality after surgical treatment of meningiomas in geriatric patients. Furthermore, we suggest a novel score ("ACKT") to preoperatively estimate the risk of PMV occurrence, which might help to guide future risk-benefit assessment and patient counseling in the geriatric meningioma population.
颅内脑膜瘤患者的手术治疗指征必须包括临床情况和个体风险效益分层，尤其是老年患者。目前尚未研究长时间机械通气（PMV）对脑膜瘤患者的潜在影响。因此，我们分析了PMV对接受脑膜瘤切除术的老年患者死亡率的影响。2009年至2019年期间，我院对261例年龄≥70岁的患者进行了颅内脑膜瘤手术治疗。PMV定义为术后有创通气超过7天。261例老年脑膜瘤患者中有17例（7%）出现术后PMV。25例老年患者（10%）在术后1年内死亡。基于年龄、术前C反应蛋白（CRP）值、卡诺夫斯基功能状态评分和肿瘤大小等变量的评分系统（“ACKT”）有助于预测术后PMV（敏感性73%，特异性84%）。PMV与老年患者脑膜瘤手术治疗后死亡率增加显著相关。此外，我们提出了一种新的评分（“ACKT”）来术前评估PMV发生风险，这可能有助于指导老年脑膜瘤患者未来的风险效益评估和患者咨询。
