Is Patient Age Associated with Perioperative Outcomes After Surgical Resection of Benign Cranial Nerve Neoplasms?

Abstract

OBJECTIVE:

Previous studies have demonstrated that increasing age is associated with decreased rates of operative management and gross total resection in patients with vestibular schwannomas.

METHODS:

The American College of Surgeons National Surgical Quality Improvement Program data registry was used for this retrospective cohort analysis. Patients enrolled in the registry from 2007 to 2013 with a diagnosis of a benign neoplasm of a cranial nerve were included. The association between age and postoperative morbidity and mortality was evaluated by the use of multivariable logistic regression analyses.

RESULTS:

Of 565 patients included for analysis, the mean (median) age was 51 (53) years. Three clusters were evaluated: <50, 50-69, and ≥70 years. Mortality (0% vs. 1.03% vs. 4.55%, P = 0.012), stroke (0% vs. 0.69% vs. 6.82%, P < 0.001), and ventilator weaning failure (0.43% vs. 2.41% vs. 6.82%, P = 0.014) increased with age. Mean age was significantly greater among patients who died (70.60 vs. 50.87 years, P = 0.002) or had a stroke (68.00 vs. 50.89 years, P = 0.006), cardiac arrest (71.50 vs. 50.89 years, P = 0.038), or coma (74.00 vs. 50.96 years, P = 0.020) and those who failed ventilator weaning (62.55 vs. 50.82, P = 0.006). Age as both a continuous (odds ratio 1.10, 95% confidence interval 1.03-1.18) and categorical variable (age 70+ years odds ratio 78.88, 95% confidence interval 3.41-1825.57) was associated with an increased odds of composite morbidity.

CONCLUSIONS:

In patients undergoing surgery for benign cranial nerve neoplasms, increasing age is associated with increased mortality, stroke, coma, and ventilator weaning failure. Composite complication rates are significantly greater in patients ≥70 years, with a near 80-fold increased risk of complications.

• Authors: Brandon A McCutcheon, Jennifer Grauberger, Meghan Murphy, Panagiotis Kerezoudis, Lorenzo Rinaldo, Daniel Shepherd, Patrick Maloney, Kendall Snyder, Bob S Carter, Mohamad Bydon, Jamie J Van Gompel, Michael J Link, Mayo Clinic Neuro-Informatics Laboratory
• Journal: World neurosurgery (World Neurosurg) Vol. 89 Pg. 101-7 (May 2016) ISSN: 1878-8769 [Electronic] United States
• PMID: 26855306 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 Elsevier Inc. All rights reserved.

Topics

• Adolescent
• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Cranial Nerve Neoplasms (mortality, surgery)
• Cranial Nerves (surgery)
• Female
• Humans
• Logistic Models
• Male
• Middle Aged
• Multivariate Analysis
• Postoperative Complications (mortality)
• ROC Curve
• Registries
• Retrospective Studies
• Young Adult