Document Detail


One-year outcome after neurosurgery for intracranial tumor in elderly patients.
MedLine Citation:
PMID:  20622683     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The number of elderly patients proposed for brain tumor removal is increasing. Only few data on long-term functional prognosis after intracranial surgery are available.
MATERIALS AND METHODS: Prospective, observational study of all patients greater than 70 year of age operated for intracranial tumors. Two scales for health status evaluation were used: Karnofsky Performance Scale (KPS) and Activities of Daily Living (ADL) score. Data were expressed as medians (first to third quartiles). The primary endpoint was the probability to remain nondependant (ADL>3 and KPS≥70%) after 1 year.
RESULTS: Between 2003 and 2007, 90 patients were included: 46 (51.1%) meningioma, 17 (18.9%) high-grade glioma, and 11 (12.2%) metastasis. At hospital admission, age was 73.50 years (71.25-76.00), American Society of Anesthesiology score 2 (2 to 3), KPS 80% (70-90), ADL 5.5 (4.5 to 6.0). Two patients died during the first 28 days, 3 others during the first year. Both KPS and ADL decreased after 1 year: KPS 80% (70 to 90; mean: 80%) at hospital admission versus 80% (60 to 90) at 1 year (mean: 70%), P=0.003; ADL 5.5 (4.5 to 6.0) at hospital admission versus 5.0 (3.25 to 5.50) at 1 year, P=0.001. In multivariate analysis, 2 preoperative parameters were associated with autonomy at 1 year: the ADL at hospital admission and meningioma as histologic type.
CONCLUSIONS: In this series of elderly patients, intracranial tumor surgery was associated with low 1-year mortality. Meningioma was associated with a better postoperative functional outcome. Preoperative ADL score was a predictive of functional evolution 1 year after the surgery.
Authors:
Romain Pirracchio; Matthieu Resche-Rigon; Damien Bresson; Benedetta Basta; Stéphane Welschbillig; Laurent Heyer; Hakim Kechiche; Catarina Madadaki; Alain Chollet; Anne Claire Lukaszewicz; Alexandre Mebazaa; Bernard George; Didier Payen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgical anesthesiology     Volume:  22     ISSN:  1537-1921     ISO Abbreviation:  J Neurosurg Anesthesiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-16     Completed Date:  2011-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8910749     Medline TA:  J Neurosurg Anesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  342-6     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Critical Care and SAMU, Lariboisiére Hospital, Paris, France. romain.pirracchio@lrb.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Aged
Brain Neoplasms / pathology,  surgery*
Female
Forecasting
Glioma / surgery
Humans
Independent Living
Karnofsky Performance Status
Longitudinal Studies
Male
Meningioma / surgery
Neoplasm Metastasis
Neurosurgical Procedures*
Prospective Studies
Survival Analysis
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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