Elbadry Rasha, Asemota Anthony O, Edelbach Brandon, Huang Lei, Bannout Firas, Boling Warren
Department of Neurosurgery, Loma Linda University Medical Center, Loma Linda, California, USA.
Department of Basic Science, Loma Linda University, Loma Linda, California, USA.
Behav Neurol. 2025 Jul 9;2025:5717503. doi: 10.1155/bn/5717503. eCollection 2025.
Epilepsy/seizures in meningioma patients may occur pre- or postoperatively, causing significant morbidity and impaired quality of life. Surgical excision is considered a standard management with variable rates of epilepsy/seizure resolution reported after surgery. Employing a national database, we examined the pre- and postoperative incidences of epilepsy/seizures and risk factors associated with postoperative epilepsy/seizures in patients readmitted within 30 days and/or 90 days following meningioma resection. The 2010-2014 Nationwide Readmissions Database was analyzed. Consecutive patients undergoing surgery for meningioma resection were identified using appropriate ICD-9-CM codes. Standard descriptive techniques and multivariate regression were used to identify predictors of postoperative epilepsy/seizure after discharge. Among 46,107 patients undergoing meningioma resection at index hospitalization, 20.40% ( = 9408) had preoperative epilepsy/seizure diagnosis. The mean patient age was 58.37 ± 13.85 years. Patients with preoperative epilepsy/seizures were more likely to be male ( < 0.001), frail ( < 0.001), and with higher comorbidity index scores ( < 0.001). The overall readmission rate was 30.36% and was higher among patients with preoperative epilepsy/seizures (36.66% vs. 28.75%, < 0.001). Respectively, 30- and 90-day readmission rates were higher among patients (13.22% vs. 11.73%, < 0.001) and (23.25% vs 20.30%, = 0.04) with epilepsy/seizure diagnosis at index admission. Predictors of postoperative epilepsy/seizures at 30- and 90-day readmissions included the preoperative epilepsy/seizure, malignant meningioma, peritumoral cerebral edema, and higher comorbidity index scores, while male sex was significant only at 30-day readmissions. Intraoperative electrocorticography was associated with a decreased likelihood of postoperative epilepsy/seizures. Development of epilepsy/seizures after meningioma resection is likely multifactorial. Identifying factors associated with postoperative epilepsy/seizures after discharge is important in triaging and closer monitoring of at-risk patients and for adapting management to help improve outcomes.
脑膜瘤患者的癫痫发作可发生在术前或术后，会导致严重的发病率和生活质量受损。手术切除被认为是一种标准治疗方法，术后癫痫发作缓解率各不相同。我们利用一个全国性数据库，研究了脑膜瘤切除术后30天内和/或90天内再次入院患者术前和术后癫痫发作的发生率以及与术后癫痫发作相关的危险因素。分析了2010 - 2014年全国再入院数据库。使用适当的ICD - 9 - CM编码识别接受脑膜瘤切除术的连续患者。采用标准描述性技术和多变量回归分析来确定出院后术后癫痫发作的预测因素。在首次住院接受脑膜瘤切除术的46107例患者中，20.40%（n = 9408）术前诊断为癫痫发作。患者平均年龄为58.37±13.85岁。术前有癫痫发作的患者更可能为男性（P < 0.001）、身体虚弱（P < 0.001）且合并症指数评分更高（P < 0.001）。总体再入院率为30.36%，术前有癫痫发作的患者再入院率更高（36.66%对28.75%，P < 0.001）。在首次入院诊断为癫痫发作的患者中，30天和90天再入院率分别更高（13.22%对11.73%，P < 0.001）和（23.25%对20.30%，P = 0.04）。30天和90天再入院时术后癫痫发作的预测因素包括术前癫痫发作、恶性脑膜瘤、瘤周脑水肿和更高的合并症指数评分，而男性仅在30天再入院时具有统计学意义。术中皮质脑电图监测与术后癫痫发作可能性降低相关。脑膜瘤切除术后癫痫发作的发生可能是多因素的。识别出院后与术后癫痫发作相关的因素对于对高危患者进行分类和密切监测以及调整治疗以改善预后非常重要。
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