Metabolic Syndrome Associated with Increased Rates of Medical Complications After Intracranial Tumor Resection

Anna M. Nia, Daniel W. Branch, Ken Maynard, Thomas Frank, Dmitry Zavlin, Joel Patterson, Rishi Rajiv Lall

Research output: Contribution to journalArticle

Abstract

Background: When diagnosed simultaneously, obesity, diabetes, and hypertension form a medical constellation called metabolic syndrome (MetS). The prevalence of MetS in Western cultures has been on a steady increase and MetS has been associated with increased postoperative complications in multiple surgical settings. Objective: In this study, we evaluate the relationship between MetS and the outcomes of craniotomy for supratentorial brain tumor. Methods: Cases of craniotomy for supratentorial brain tumors were extracted from the American College of Surgeons National Surgical Quality Improvement Program for 2012–2016. The 15,136 patients identified were divided into 2 cohorts based on the presence (4.1%) or absence (95.9%) of MetS. We compared the 2 cohorts for preoperative comorbidities, intraoperative details, and postoperative morbidity and mortality. Results: Patients in the MetS+ cohort were significantly older (63.4 vs. 56.1 years) and were more likely to show comorbidities of various organ systems (all P ≤ 0.05). However, operative times were similar (P = 0.573). The number of medical complications was almost double in patients with MetS (15.8% vs. 8.5%; P ≤ 0.001). Unplanned readmissions (14.6% vs. 10.4%; P = 0.004), reoperations (6.9% vs. 4.6%; P = 0.007), and mortality (5.6% vs. 2.9%; P ≤ 0.001) were also more frequent in our MetS+ group. Nevertheless, surgical complications localized to the operative site were not statistically increased (7.4% vs. 5.8%; P = 0.098). Conclusions: A diagnosis of MetS does not seem to be associated with increased rates of surgical site events. However, neurosurgeons should be aware that these patients have a significantly higher likelihood of general medical complications, readmissions, reoperations, and death.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StatePublished - Jan 1 2019

Fingerprint

Neoplasms
Supratentorial Neoplasms
Craniotomy
Reoperation
Brain Neoplasms
Comorbidity
Mortality
Operative Time
Quality Improvement
Obesity
Hypertension
Morbidity

Keywords

  • Hypertension
  • Medical complications
  • Metabolic syndrome
  • Obesity
  • Postoperative outcomes
  • Supratentorial tumor resection
  • Surgical complications

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Metabolic Syndrome Associated with Increased Rates of Medical Complications After Intracranial Tumor Resection. / Nia, Anna M.; Branch, Daniel W.; Maynard, Ken; Frank, Thomas; Zavlin, Dmitry; Patterson, Joel; Lall, Rishi Rajiv.

In: World Neurosurgery, 01.01.2019.

Research output: Contribution to journalArticle

@article{8f12be86fcfb490f9e351b2a8bb7c3fd,
title = "Metabolic Syndrome Associated with Increased Rates of Medical Complications After Intracranial Tumor Resection",
abstract = "Background: When diagnosed simultaneously, obesity, diabetes, and hypertension form a medical constellation called metabolic syndrome (MetS). The prevalence of MetS in Western cultures has been on a steady increase and MetS has been associated with increased postoperative complications in multiple surgical settings. Objective: In this study, we evaluate the relationship between MetS and the outcomes of craniotomy for supratentorial brain tumor. Methods: Cases of craniotomy for supratentorial brain tumors were extracted from the American College of Surgeons National Surgical Quality Improvement Program for 2012–2016. The 15,136 patients identified were divided into 2 cohorts based on the presence (4.1{\%}) or absence (95.9{\%}) of MetS. We compared the 2 cohorts for preoperative comorbidities, intraoperative details, and postoperative morbidity and mortality. Results: Patients in the MetS+ cohort were significantly older (63.4 vs. 56.1 years) and were more likely to show comorbidities of various organ systems (all P ≤ 0.05). However, operative times were similar (P = 0.573). The number of medical complications was almost double in patients with MetS (15.8{\%} vs. 8.5{\%}; P ≤ 0.001). Unplanned readmissions (14.6{\%} vs. 10.4{\%}; P = 0.004), reoperations (6.9{\%} vs. 4.6{\%}; P = 0.007), and mortality (5.6{\%} vs. 2.9{\%}; P ≤ 0.001) were also more frequent in our MetS+ group. Nevertheless, surgical complications localized to the operative site were not statistically increased (7.4{\%} vs. 5.8{\%}; P = 0.098). Conclusions: A diagnosis of MetS does not seem to be associated with increased rates of surgical site events. However, neurosurgeons should be aware that these patients have a significantly higher likelihood of general medical complications, readmissions, reoperations, and death.",
keywords = "Hypertension, Medical complications, Metabolic syndrome, Obesity, Postoperative outcomes, Supratentorial tumor resection, Surgical complications",
author = "Nia, {Anna M.} and Branch, {Daniel W.} and Ken Maynard and Thomas Frank and Dmitry Zavlin and Joel Patterson and Lall, {Rishi Rajiv}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.wneu.2019.03.046",
language = "English (US)",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Metabolic Syndrome Associated with Increased Rates of Medical Complications After Intracranial Tumor Resection

AU - Nia, Anna M.

AU - Branch, Daniel W.

AU - Maynard, Ken

AU - Frank, Thomas

AU - Zavlin, Dmitry

AU - Patterson, Joel

AU - Lall, Rishi Rajiv

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: When diagnosed simultaneously, obesity, diabetes, and hypertension form a medical constellation called metabolic syndrome (MetS). The prevalence of MetS in Western cultures has been on a steady increase and MetS has been associated with increased postoperative complications in multiple surgical settings. Objective: In this study, we evaluate the relationship between MetS and the outcomes of craniotomy for supratentorial brain tumor. Methods: Cases of craniotomy for supratentorial brain tumors were extracted from the American College of Surgeons National Surgical Quality Improvement Program for 2012–2016. The 15,136 patients identified were divided into 2 cohorts based on the presence (4.1%) or absence (95.9%) of MetS. We compared the 2 cohorts for preoperative comorbidities, intraoperative details, and postoperative morbidity and mortality. Results: Patients in the MetS+ cohort were significantly older (63.4 vs. 56.1 years) and were more likely to show comorbidities of various organ systems (all P ≤ 0.05). However, operative times were similar (P = 0.573). The number of medical complications was almost double in patients with MetS (15.8% vs. 8.5%; P ≤ 0.001). Unplanned readmissions (14.6% vs. 10.4%; P = 0.004), reoperations (6.9% vs. 4.6%; P = 0.007), and mortality (5.6% vs. 2.9%; P ≤ 0.001) were also more frequent in our MetS+ group. Nevertheless, surgical complications localized to the operative site were not statistically increased (7.4% vs. 5.8%; P = 0.098). Conclusions: A diagnosis of MetS does not seem to be associated with increased rates of surgical site events. However, neurosurgeons should be aware that these patients have a significantly higher likelihood of general medical complications, readmissions, reoperations, and death.

AB - Background: When diagnosed simultaneously, obesity, diabetes, and hypertension form a medical constellation called metabolic syndrome (MetS). The prevalence of MetS in Western cultures has been on a steady increase and MetS has been associated with increased postoperative complications in multiple surgical settings. Objective: In this study, we evaluate the relationship between MetS and the outcomes of craniotomy for supratentorial brain tumor. Methods: Cases of craniotomy for supratentorial brain tumors were extracted from the American College of Surgeons National Surgical Quality Improvement Program for 2012–2016. The 15,136 patients identified were divided into 2 cohorts based on the presence (4.1%) or absence (95.9%) of MetS. We compared the 2 cohorts for preoperative comorbidities, intraoperative details, and postoperative morbidity and mortality. Results: Patients in the MetS+ cohort were significantly older (63.4 vs. 56.1 years) and were more likely to show comorbidities of various organ systems (all P ≤ 0.05). However, operative times were similar (P = 0.573). The number of medical complications was almost double in patients with MetS (15.8% vs. 8.5%; P ≤ 0.001). Unplanned readmissions (14.6% vs. 10.4%; P = 0.004), reoperations (6.9% vs. 4.6%; P = 0.007), and mortality (5.6% vs. 2.9%; P ≤ 0.001) were also more frequent in our MetS+ group. Nevertheless, surgical complications localized to the operative site were not statistically increased (7.4% vs. 5.8%; P = 0.098). Conclusions: A diagnosis of MetS does not seem to be associated with increased rates of surgical site events. However, neurosurgeons should be aware that these patients have a significantly higher likelihood of general medical complications, readmissions, reoperations, and death.

KW - Hypertension

KW - Medical complications

KW - Metabolic syndrome

KW - Obesity

KW - Postoperative outcomes

KW - Supratentorial tumor resection

KW - Surgical complications

UR - http://www.scopus.com/inward/record.url?scp=85064073586&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064073586&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2019.03.046

DO - 10.1016/j.wneu.2019.03.046

M3 - Article

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -