In order to weigh the risks of surgery against the presumed advantages, it is important to have specific knowledge about complication rates.
To study the surgical mortality and rate of reoperations for hematomas and infections after intracranial surgery for brain tumors in a large, contemporary, single-institution consecutive series.
Material & Methods
All adult patients from a well-defined population of 2.7 mill. inhabitants who underwent craniotomies for intracranial tumors at Oslo University Hospital during 2003 to 2008 were included (n=2630). The patients were identified from our prospectively collected database and their charts studied retrospectively. Follow-up was 100%.
The overall surgical mortality, defined as death within 30 days of surgery, was 2.3% (n=60). The mortality rates for high- and low-grade gliomas, meningiomas, and metastases were 2.9%, 1.0%, 0.9%, and 4.5%, respectively. Age>60 (Odds ratio 1.84, p<0.05) and biopsy compared to resection (Odds ratio 4.67, p<0.01) were significantly positively associated with increased surgical mortality. Hematomas accounted for 35% of the surgical mortality. Postoperative hematomas needing evacuation occurred in 2.1% (n=54). Age >60 was significantly correlated to increased risk of postoperative hematomas (Odds ratio 2.43, p<0.001). A total of 39 patients (1.5%) were reoperated for postoperative infection. Meningiomas had an increased risk of infections compared to high grade gliomas (Odds ratio 4.61, p<0.001).
Mortality within 30 days of surgery was 2.3%, with age >60 and biopsy vs. resection being the two factors significantly associated with increased mortality. Postoperative hematomas caused about one third of the surgical mortality. The overall risk associated with surgery for intracranial tumors is low.