Abstract:
BACKGROUND:Asymptomatic or minor symptom meningiomas (AMSMs) in the elderly are incidental findings, with no consensus reached on the optimal management strategy. In the present study, we aimed to determine the surgical risk factors for elderly patients with AMSMs using a nationwide registry database in Japan. METHODS:We identified patients with surgically treated AMSMs using the Diagnosis Procedure Combination database from 2010 to 2015 and reviewed the medical records for age (<65 years; pre-elderly, 65-74 years; and elderly, ≥75 years), sex, Barthel index (BI) score, medical history, tumor location, and complications. An AMSM was defined by a BI score of 100 points at admission. The risk factors for all stroke complications, BI deterioration at discharge, and in-hospital mortality were determined using multivariate logistic regression analyses. RESULTS:From a total of 10,535 patients with meningioma, 6628 were included. Advanced age was a significant risk factor (odds ratio, 3.54; 95% confidence interval, 2.80-4.46) for BI deterioration but not for all-stroke complications or in-hospital mortality. Midline and posterior fossa tumors, diabetes mellitus, and chronic heart disease were significant risk factors for in-hospital mortality. CONCLUSIONS:For elderly patients with surgically treated AMSMs, advanced age was a prominent risk factor for functional decline at discharge. Our study identified several factors that should be evaluated before proceeding with surgery for AMSMs in elderly and pre-elderly patients. These findings could, not only improve decision-making among clinicians treating patients with AMSMs, but also help in predicting the results of surgery for elderly patients with AMSMs.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Ikawa F,Isobe N,Michihata N,Oya S,Ohata K,Saito K,Yoshida K,Fushimi K,Yasunaga H,Tominaga T,Kurisu Kdoi
10.1016/j.wneu.2021.01.001subject
Has Abstractpub_date
2021-01-11 00:00:00eissn
1878-8750issn
1878-8769pii
S1878-8750(21)00020-6pub_type
杂志文章abstract::The insula plays a crucial role in speech planning due to its connections with cortical and subcortical areas. Surgical management of cavernous malformation (CM) of the insula consists of total resection of the lesion and the surrounding gliosis to avoid or reduce seizures. When located in the dominant hemisphere, an ...
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journal_title:World neurosurgery
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journal_title:World neurosurgery
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pub_type: 杂志文章
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更新日期:2020-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2014-07-01 00:00:00
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更新日期:2020-12-01 00:00:00
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更新日期:2021-01-01 00:00:00
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更新日期:2019-07-01 00:00:00
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更新日期:2019-03-01 00:00:00
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更新日期:2018-06-01 00:00:00
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更新日期:2019-12-01 00:00:00