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颅内肿瘤切除术后患者年龄与术后发病率及死亡率的关联。

The association of patient age with postoperative morbidity and mortality following resection of intracranial tumors.

作者信息

Yang Yang, Zeitlberger Anna M, Neidert Marian C, Staartjes Victor E, Broggi Morgan, Zattra Costanza Maria, Vasella Flavio, Velz Julia, Bartek Jiri, Fletcher-Sandersjöö Alexander, Förander Petter, Kalasauskas Darius, Renovanz Mirjam, Ringel Florian, Brawanski Konstantin R, Kerschbaumer Johannes, Freyschlag Christian F, Jakola Asgeir S, Sjåvik Kristin, Solheim Ole, Schatlo Bawarjan, Sachkova Alexandra, Bock Hans Christoph, Hussein Abdelhalim, Rohde Veit, Broekman Marike L D, Nogarede Claudine O, Lemmens Cynthia M C, Kernbach Julius M, Neuloh Georg, Krayenbühl Niklaus, Ferroli Paolo, Regli Luca, Bozinov Oliver, Stienen Martin N

机构信息

Department of Neurosurgery, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland.

Department of Neurosurgery, University Hospital Zurich and Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland.

出版信息

Brain Spine. 2021 Oct 21;1:100304. doi: 10.1016/j.bas.2021.100304. eCollection 2021.

Abstract

INTRODUCTION

The postoperative functional status of patients with intracranial tumors is influenced by patient-specific factors, including age.

RESEARCH QUESTION

This study aimed to elucidate the association between age and postoperative morbidity or mortality following the resection of brain tumors.

MATERIAL AND METHODS

A multicenter database was retrospectively reviewed. Functional status was assessed before and 3-6 months after tumor resection by the Karnofsky Performance Scale (KPS). Uni- and multivariable linear regression were used to estimate the association of age with postoperative change in KPS. Logistic regression models for a ≥10-point decline in KPS or mortality were built for patients ≥75 years.

RESULTS

The total sample of 4864 patients had a mean age of 56.4 ​± ​14.4 years. The mean change in pre-to postoperative KPS was -1.43. For each 1-year increase in patient age, the adjusted change in postoperative KPS was -0.11 (95% CI -0.14 - - 0.07). In multivariable analysis, patients ≥75 years had an odds ratio of 1.51 to experience postoperative functional decline (95%CI 1.21-1.88) and an odds ratio of 2.04 to die (95%CI 1.33-3.13), compared to younger patients.

DISCUSSION

Patients with intracranial tumors treated surgically showed a minor decline in their postoperative functional status. Age was associated with this decline in function, but only to a small extent.

CONCLUSION

Patients ≥75 years were more likely to experience a clinically meaningful decline in function and about two times as likely to die within the first 6 months after surgery, compared to younger patients.

摘要

引言

颅内肿瘤患者的术后功能状态受包括年龄在内的患者个体因素影响。

研究问题

本研究旨在阐明年龄与脑肿瘤切除术后发病率或死亡率之间的关联。

材料与方法

对一个多中心数据库进行回顾性分析。通过卡诺夫斯基功能状态量表(KPS)在肿瘤切除术前及术后3 - 6个月评估功能状态。采用单变量和多变量线性回归估计年龄与术后KPS变化的关联。为75岁及以上患者建立KPS下降≥10分或死亡率的逻辑回归模型。

结果

4864例患者的总样本平均年龄为56.4±14.4岁。术前至术后KPS的平均变化为 - 1.43。患者年龄每增加1岁,术后KPS的校正变化为 - 0.11(95%CI - 0.14 - - 0.07)。在多变量分析中,与年轻患者相比,75岁及以上患者术后功能下降的比值比为1.51(95%CI 1.21 - 1.88),死亡的比值比为2.04(95%CI 1.33 - 3.13)。

讨论

接受手术治疗的颅内肿瘤患者术后功能状态有轻微下降。年龄与这种功能下降有关,但程度较小。

结论

与年轻患者相比,75岁及以上患者在术后6个月内更有可能出现具有临床意义的功能下降,死亡可能性约为年轻患者的两倍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63d9/9560674/bf22c1239ffd/gr1.jpg

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