Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94131, USA.
Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94131, USA; Miami Neuroscience Institute, Baptist Health South Florida, Miami, FL 33176, USA.
J Clin Neurosci. 2021 Jun;88:88-94. doi: 10.1016/j.jocn.2021.03.032. Epub 2021 Apr 1.
Meningioma incidence increases with age, yet limited data exist on how comorbidities impact complication rates in elderly patients undergoing meningioma resection. The objective of this study was to report surgical outcomes and identify risk factors for perioperative complications.
We performed a retrospective study of patients 75 years and older undergoing meningioma resection. Outcomes included survival and complications. Major complications were those requiring surgical intervention or causing permanent neurological deficit. Recursive partitioning, Kaplan-Meier survival, univariate and multi-variate (MVA) analyses were performed.
From 1996 to 2014, 103 patients with a median age of 79 years (IQR 77-83 years) underwent cranial meningioma resection. Median follow-up was 5.8 years (IQR 1.7-8.7 years). Median actuarial survival was 10.5 years. Complications occurred in 32 patients (31.1%), and 13 patients (12.6%) had multiple complications. Major complications occurred in 16 patients (15.5%). Increasing age was not a significant predictor of any (p = 0.6408) or major complication (p = 0.8081). On univariate analysis, male sex, Charlson Comorbidity Index greater than 8, and cardiovascular comorbidities were significantly associated with major complications. On MVA only cardiovascular comorbidities (OR 3.94, 95% CI 1.05-14.76, p = 0.0238) were significantly associated with any complication. All patients with major complications had cardiovascular comorbidities, and on MVA male gender (OR 3.78, 95%CI 1.20-11.93, p = 0.0212) was associated with major complications.
Cardiovascular comorbidities and male gender are significant risk factors for complications after meningioma resection in patients aged 75 years and older. While there is morbidity associated with meningioma resection in this cohort, there is also excellent long-term survival.
脑膜瘤的发病率随年龄增长而增加，但关于合并症如何影响老年脑膜瘤切除术患者并发症发生率的数据有限。本研究的目的是报告手术结果并确定围手术期并发症的危险因素。
我们对 75 岁及以上行脑膜瘤切除术的患者进行了回顾性研究。结果包括生存率和并发症。主要并发症是需要手术干预或导致永久性神经功能缺损的并发症。采用递归分区、Kaplan-Meier 生存分析、单变量和多变量（MVA）分析。
1996 年至 2014 年间，103 例年龄中位数为 79 岁（IQR 77-83 岁）的患者接受了颅脑膜瘤切除术。中位随访时间为 5.8 年（IQR 1.7-8.7 年）。中位生存时间为 10.5 年。32 例（31.1%）患者发生并发症，13 例（12.6%）患者发生多种并发症。16 例（15.5%）患者发生主要并发症。年龄增加与任何（p=0.6408）或主要并发症（p=0.8081）均无显著相关性。单变量分析显示，男性、Charlson 合并症指数大于 8 分和心血管合并症与主要并发症显著相关。多变量分析仅显示心血管合并症（OR 3.94，95%CI 1.05-14.76，p=0.0238）与任何并发症显著相关。所有发生主要并发症的患者均有心血管合并症，多变量分析显示男性（OR 3.78，95%CI 1.20-11.93，p=0.0212）与主要并发症显著相关。
心血管合并症和男性是 75 岁及以上脑膜瘤切除术患者并发症的重要危险因素。虽然该队列脑膜瘤切除术存在发病率，但也有极好的长期生存率。
