Factors predicting complications, neurologic deterioration and mortality for patients with meningioma surgery: An observational study

Abstract

Background: Meningiomas are the second most common intracranial neoplasm, contributing to 30% of all intracranial tumors. Clinical examination, anatomical pathology testing, CT, and MRI are required to confirm the meningioma diagnosis. Surgery is the therapy of choice for meningiomas. Understanding factors affecting the outcome of meningioma surgery is critical to predicting the outcome of meningioma surgery. Methods: A retrospective analytic method was conducted in this study, which included meningioma patients who underwent surgery at Dr. Soetomo General Academic Hospital between January 2014 and December 2020. The study incorporated secondary data in the form of medical records. Data collection was followed by binomial logistic regression analysis using SPSS IBM 25. Results:  A total of 440 samples of patients with meningiomas were obtained through medical records. Post-operative hematoma (2.5%), postoperative infection (3.0%), neurologic deterioration (3.9%), and 30-day mortality (2.3%) were the postoperative complications reported. Emergency surgery was found to be a significant predictor of postoperative hematoma (p=0.025; OR=4.539; 95% CI: 1.211-17.006), postoperative infection (p=0.015; OR=4.777; 95% CI: 1.362-16.751), neurologic deterioration (p=0.022; OR=5,151; 95% CI: 1,271-20,882), and 30-day mortality (p=0.002; OR=17,874; 95% CI: 2,933-108,915). Simpson Grade IV (p=0.016; OR=33,524; 95% CI: 1.905-590.056) was a significant predictive factor for postoperative hematomas. Post-operative hematoma was a significant predictive factor for neurologic deterioration (p=0.000; OR=235,807; 95% CI: 38,058-1461,069) and 30-day mortality (p=0.001; OR=40,047; 95% CI: 4,985-321,699). Conclusions: Post-operative complications following meningioma surgery may result in high morbidity and mortality. The predictive factors for meningioma surgery complications were identified in this study. Knowledge of these factors may aid in preventing or predicting meningioma surgery complications.