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

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

World Neurosurg. 2016 Feb 5;

Authors: McCutcheon BA, Grauberger J, Murphy M, Kerezoudis P, Rinaldo L, Shepherd D, Maloney P, Snyder K, Carter BS, Bydon M, Van Gompel JJ, Link MJ, Mayo Clinic Neuro-Informatics Laboratory

Abstract
OBJECTIVE: Prior literature has demonstrated that increasing age is associated with decreased rates of operative management and gross total resection in patients with vestibular schwannomas.
METHODS: The ACS-NSQIP data registry was used for this retrospective cohort analysis. Patients enrolled in the registry from 2007-2013 with a diagnosis of a benign neoplasm of a cranial nerve were included. The association between age and postoperative morbidity and mortality was evaluated using 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 suffered death(70.60 vs. 50.87 years, p=0.002), stroke(68.00 vs 50.89 years, p=0.006), cardiac arrest(71.50 vs 50.89 years, p=0.038), 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(OR 1.10, 95% CI 1.03 to 1.18) and categorical variable(age 70+ years OR 78.88, 95% CI 3.41 to 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 higher in patients ≥70 years, with a near 80 fold increased risk of complications.

PMID: 26855306 [PubMed - as supplied by publisher]

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