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Older meningioma patients: a retrospective population-based study of risk factors for morbidity and mortality after neurosurgery.
Örebro University, School of Medical Sciences. Department of Oncology.ORCID iD: 0000-0001-9858-6684
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Oncology.ORCID iD: 0000-0001-6059-0194
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Neurosurgery.
2022 (English)In: Acta Neurochirurgica, ISSN 0001-6268, E-ISSN 0942-0940, Vol. 164, p. 2987-2997Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Meningioma is the most common primary CNS tumour. Most meningiomas are benign, and most patients are 65 years or older. Surgery is usually the primary treatment option. Most prior studies on early surgical outcomes in older patients with meningioma are small, and there is a lack of larger population-based studies to guide clinical decision-making. We aimed to explore the risks for perioperative mortality and morbidity in older patients with meningioma and to investigate changes in surgical incidence over time.

METHODS: In this retrospective population-based study on patients in Sweden, 65 years or older with surgery 1999-2017 for meningioma, we used data from the Swedish Brain Tumour Registry. We analysed factors contributing to perioperative mortality and morbidity and used official demographic data to calculate yearly incidence of surgical procedures for meningioma.

RESULTS: The final study cohort included 1676 patients with a 3.1% perioperative mortality and a 37.6% perioperative morbidity. In multivariate analysis, higher age showed a statistically significant association with higher perioperative mortality, whereas larger tumour size and having preoperative symptoms were associated with higher perioperative morbidity. A numerical increased rate of surgical interventions after 2012 was observed, without evidence of worsening short-term surgical outcomes.

CONCLUSIONS: Higher mortality with increased age and higher morbidity risk in larger and/or symptomatic tumours imply a possible benefit from considering surgery in selected older patients with a growing meningioma before the development of tumour-related symptoms. This study further underlines the need for a standardized method of reporting and classifying complications from neurosurgery.

Place, publisher, year, edition, pages
Springer, 2022. Vol. 164, p. 2987-2997
Keywords [en]
Elderly, Meningioma, Neurosurgical complications, Perioperative complications, Surgical complications
National Category
Surgery Neurology
Identifiers
URN: urn:nbn:se:oru:diva-100721DOI: 10.1007/s00701-022-05336-1ISI: 000842607700001PubMedID: 35978200Scopus ID: 2-s2.0-85136197733OAI: oai:DiVA.org:oru-100721DiVA, id: diva2:1688611
Funder
Örebro UniversityRegion Örebro County, OLL-591961 OLL-869421Available from: 2022-08-19 Created: 2022-08-19 Last updated: 2023-12-08Bibliographically approved

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Löfgren, DavidValachis, AntoniosOlivecrona, Magnus

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