Key result
Frontal craniotomy and on-call surgery linked to ~196% higher risk of early unplanned reoperation.
Why the study?
Surgical treatment of brain tumors carries a high risk of unplanned reoperation, but predictors of early reoperation in supratentorial brain tumors are not well defined.
What are the predictors of early unplanned reoperation in patients undergoing craniotomy for supratentorial brain tumors?
Observational (n=328)
What are the predictors of early unplanned reoperation in patients undergoing craniotomy for supratentorial brain tumors?
Odds Ratio: 2.961 (95% CI 1.042–8.406)
p-value: p=0.04
Frontal craniotomy and surgeries performed during on-call hours are independent predictors of early unplanned reoperation in patients with supratentorial brain tumors.
May inform risk stratification for supratentorial craniotomy; hypothesis-generating pending prospective validation.
Background Surgical treatment of brain tumors were proved to be at highest risk of unplanned reoperation. Therefore, we decided to find possible predictors of complications leading to early unplanned reoperations among patients with supratentorial brain tumors. Methods We retrospectively analysed 328 patients who underwent craniotomy due to supratentorial brain tumor. Early reoperation was defined as reoperation during the same hospital stay. To determine the potential predictors of early reoperation we used univariate and multivariate logistic regression analyses. Results A total of 22 (6.51%) patients underwent unplanned reoperation. Those patients significantly more often were diagnosed with high grade glioma (81.82% vs. 55.70%; p = 0.02). They had lower Red Blood Cells count (4.16 ± 0.82 vs. 4.60 ± 0.56 10 3 /μl; p < 0.01) and haemoglobin (12.58 ± 2.46 vs. 13.7 ± 1.72 g/dl; p < 0.01) and lower haematocrit (36.93 ± 6.84 vs. 39.94 ± 4.66%; p < 0.01) preceding surgery. Surgeries of reoperated patients more often were performed during “on call” hours (17.65% vs. 4.49%; p = 0.02). After adjustment for possible confounders frontal craniotomy (OR: 2.961; 95% CI: 1.042–8.406; p = 0.04)and “on call” hours of surgery (OR: 2.961; 1.042–8.406; p = 0.04) remained independently associated with higher risk of reoperation. Conclusions Frontal craniotomy and surgery during “on call” hours are independently associated with higher risk of reoperation in supratentorial brain tumors.
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Kwinta et al. (2018) conducted an observational in Supratentorial brain tumors (n=328). Frontal craniotomy and 'on call' hours of surgery vs. Other craniotomy locations and regular surgery hours was evaluated on Early unplanned reoperation (during the same hospital stay) (OR 2.961, 95% CI 1.042-8.406, p=0.04). Frontal craniotomy and surgery during 'on call' hours were independently associated with a higher risk of early unplanned reoperation (OR 2.961; 95% CI 1.042-8.406; p=0.04).
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