Predictors of early reoperation after meningioma removal
Paulina Donicz, , Kornelia Kliś, Małgorzata Gackowska
Student Scientific Group at Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Poland

Aim: The aim of our study was to establish predictors of unplanned early reoperations after meningioma removal.

Introduction: Complications after neurosurgical procedures which lead to reoperation are associated with poor treatment outcome and costs. The knowledge of risk factors for complications might allow to implement specific preventive measures. However those factor are still poorly defined, especially in terms of benign brain tumours.

Methods: We retrospectively analysed 177 patients, with histologically confirmed meningiomas, hospitalized between 2014 and 2016 who underwent craniotomy. From medical records we obtained detailed medical history (previous diseases, medications, tumour characteristics, blood test results, surgery's details). Completeness of tumour resection was assessed using Simpson Grade. Early reoperation was defined as reoperation during the same hospital stay. We used χ2 test for proportional values; t-student test, Mann–Whitney U test for continuous variables. To determine the potential predictors of early reoperation we used univariate and multivariate logistic regression analyses.

Results: A total of 13 (7.34%) patients underwent unplanned early reoperation. Those patients significantly more often had retromastoid craniotomy (25.00% vs. 6.40%; p=0.047). And significantly more often suffered from ischemic heart disease (66.67% vs. 6.64%; p<0.01) and atrial fibrillation (60% vs. 6.25%; p<0.01). Reoperated patients also more often took heparin (50% vs. 6.74%; p<0.01) and anticoagulants (66.67% vs. 6.21%; p<0.01). In multivariate logistic regression analysis anticoagulants intake (OR: 31.463; 95% CI: 1.139–868.604; p=0.04) and retromastoid craniotomy (OR: 6.642; 95% CI: 1.139–38.73; p=0.034) remained independently associated with higher risk of early reoperation.

Conclusion: Patients who underwent retromastoid craniotomy, those with history of ischemic heart disease or atrial fibrillation and those who take heparin and anticoagulants are more likely to require early reoperation. Retromastoid craniotomy and anticoagulatns intake are independent risk factors for early reoperation.

Acknowledgements: To our Tutors: Jarosław Polak, MD, PhD and Roger Krzyżewski, MD.

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