Prospective review of 30-day morbidity and mortality following surgery for brain tumours in children.

PURPOSE

This study aimed to record the 30-day and inpatient morbidity and mortality in paediatric patients undergoing neurosurgery for brain tumours in a tertiary neurosciences centre over a 10-year period. The intention was to establish the frequency of significant adverse events and review the current published rates of morbidity in this patient group.

METHODS

All deaths and adverse events occurring within our department are prospectively recorded. Each adverse event was categorised, allocated a clinical impact severity score, and linked to a neurosurgical procedure wherever possible. Where a patient suffered several adverse events in the same admission, each event was recorded separately. If a patient had been discharged home, an adverse event was recorded if it occurred within 30 days of admission.

RESULTS

A total of 285 procedures were performed in 209 patients (aged < 16 years). Eighty-five significant adverse events were identified. Four clinical indicators are the following: Significant adverse event rate: 78 (27.4%) operations were linked to at least one significant adverse event. Unscheduled return to theatre rate: 33 (11.6%) operations were associated with an adverse event that resulted in an unscheduled return to theatre. Surgical site infection rate: Eight (2.8%) operations were associated with an infection. Post-procedure hydrocephalus treatment rate: 37 (13.0%) operations were followed by a further surgical procedure to treat hydrocephalus.

CONCLUSION

Complications and adverse events occur frequently following neurosurgery for intracranial tumours in children. Prospective, continuous surveillance will promote improvement in the neurosurgical care delivered to this patient group.