{"id":"14a10921-459c-45fd-9783-be6565f4d64e","slug":"outcomes-of-infratentorial-cranial-surgery-for-tumor-resection-in-older-patients-an-analysis-of-the-national-surgical-quality-improvement-program","title":"Outcomes of infratentorial cranial surgery for tumor resection in older patients: An analysis of the National Surgical Quality Improvement Program","authors":["Krissia M. Rivera Perla","Nathan J. Pertsch","Owen P. Leary","Catherine M. Garcia","Oliver Y. Tang","Steven A. Toms","Robert J. Weil"],"abstract":"Background: Poorer outcomes for infratentorial tumor resection have been reported. There is a lack of large multicenter analyses describing infratentorial surgery outcomes in older patients. We characterized outcomes in patients aged ≥65 years undergoing infratentorial cranial surgery. Methods: The National Surgical Quality Improvement Project database was queried from 2012 to 2018 for patients ≥18 years undergoing elective infratentorial cranial surgery for tumor resection. Patients were grouped into 65–74 years, ≥75 years, and 18–64 years cohorts. Multivariable regressions compared outcome measures. Results: Of 2212 patients, 28.3% were ≥65 years, of whom 24.8% were ≥75 years. Both older subpopulations had worse American Society of Anesthesiologists classification compared to controls (P < 0.01) and more comorbidities. Patients 65–74 and ≥75 years had higher rates of major complication (adjusted odds ratio [aOR] = 1.77, 95% CI = 1.13–2.79 and aOR = 3.44, 95% CI = 1.96–6.02, respectively), prolonged length of stay (LOS) (aOR = 1.89, 95% CI = 1.15–3.12 and aOR = 3.00, 95% CI = 1.65–5.44, respectively), and were more likely to be discharged to a location other than home (aOR = 2.43, 95% CI =1.73–3.4 and aOR = 3.41, 95% CI = 2.18–5.33, respectively) relative to controls. Patients ≥75 had higher rates of readmission (aOR = 1.86, 95% CI = 1.13–3.08) and mortality (aOR = 3.28, 95% CI = 1.21–8.89) at 30 days. Conclusion: Patients ≥65 years experienced more complications, prolonged LOS, and were less often discharged home than adults <65 years. Patients ≥75 years had higher rates of 30-day readmission and mortality. There is a need for careful preoperative optimization in older patients undergoing infratentorial tumor cranial surgery.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/14a10921-459c-45fd-9783-be6565f4d64e/featured/hero-1781562572500.png","publishDate":"2021-04-08T00:00:00.000Z","doi":"10.25259/SNI_25_2021","categories":["Neuro-oncology","Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2021/04/10699/SNI-12-144.pdf"}