caa a22 4500 445338172 CHVBK 20180317142802.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1245/s10434-010-1299-2 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1299-2 Predictors of Inpatient Death and Complications among Postoperative Elderly Patients with Metastatic Brain Tumors [Elektronische Daten] [Rachel Grossman, Debraj Mukherjee, David Chang, Michael Purtell, Michael Lim, Henry Brem, Alfredo Quiñones-Hinojosa] Objective: Risks of brain surgery in elderly patients with brain metastases are not well defined. This study was designed to quantify the postoperative risk for these patients after brain surgery for metastatic disease to the brain. Methods: We performed a retrospective analysis of the Nationwide Inpatient Sample (1998-2005). Patients aged 65years or older who underwent tumor resection of brain metastases were identified by ICD-9 coding. Primary outcome was inpatient death. Other outcomes included systemic postoperative complications, length of stay (LOS), and total charges. Results: A total of 4,907 patients (53.6% men) were identified. Mean age was 72.1years. Mean Charlson comorbidity score was 7.8. Inpatient mortality was 4%. The most common adverse events were pulmonary complications (3.4%). Mean length of stay was 9.2days. Mean total charges were $57,596.39. In multivariate analysis, patients up to age 80years had no significantly greater odds of inpatient death, relative to their 65- to 69-year-old counterparts. Each 1-point increase in Charlson score was associated with 12% increased odds of death, 0.52days increased LOS, and $1,710.61 higher hospital charges. Postoperative pulmonary complications, stroke, or thromboembolic events increased LOS and total charges by up to 9.6days and $57,664.42, respectively. These associations were statistically significant (P<0.05). Conclusions: Surgical resection of brain metastases among the elderly up to the ninth decade of life is feasible. Age older than 80years and higher Charlson comorbidity scores were found to be important prognostic factors for inpatient outcome. Incorporating these factors into preoperative decision making may help to select appropriately those elderly candidates for neurosurgical intervention. Society of Surgical Oncology, 2010 Grossman Rachel Neuro-Oncology Surgical Outcomes Research Laboratory, Department of Neurosurgery and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut Mukherjee Debraj Neuro-Oncology Surgical Outcomes Research Laboratory, Department of Neurosurgery and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut Chang David Neuro-Oncology Surgical Outcomes Research Laboratory, Department of Neurosurgery and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut Purtell Michael Neuro-Oncology Surgical Outcomes Research Laboratory, Department of Neurosurgery and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut Lim Michael Neuro-Oncology Surgical Outcomes Research Laboratory, Department of Neurosurgery and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut Brem Henry Neuro-Oncology Surgical Outcomes Research Laboratory, Department of Neurosurgery and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut Quiñones-Hinojosa Alfredo Neuro-Oncology Surgical Outcomes Research Laboratory, Department of Neurosurgery and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 521-528 1068-9265 18:2<521 2011 18 10434 https://doi.org/10.1245/s10434-010-1299-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1299-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Grossman Rachel Neuro-Oncology Surgical Outcomes Research Laboratory, Department of Neurosurgery and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Mukherjee Debraj Neuro-Oncology Surgical Outcomes Research Laboratory, Department of Neurosurgery and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Chang David Neuro-Oncology Surgical Outcomes Research Laboratory, Department of Neurosurgery and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Purtell Michael Neuro-Oncology Surgical Outcomes Research Laboratory, Department of Neurosurgery and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Lim Michael Neuro-Oncology Surgical Outcomes Research Laboratory, Department of Neurosurgery and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Brem Henry Neuro-Oncology Surgical Outcomes Research Laboratory, Department of Neurosurgery and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Quiñones-Hinojosa Alfredo Neuro-Oncology Surgical Outcomes Research Laboratory, Department of Neurosurgery and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 521-528 1068-9265 18:2<521 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer