Craniotomy for Resection of Meningioma: An Age-Stratified Analysis of the MarketScan Longitudinal Database

World Neurosurg. 2015 Dec;84(6):1864-70. doi: 10.1016/j.wneu.2015.08.018. Epub 2015 Aug 28.

Abstract

Objective: We sought to describe complications after resection for meningioma with the use of longitudinal administrative data, which our group has shown recently to be superior to nonlongitudinal administrative data.

Methods: We identified patients who underwent resection for meningioma between 2010 and 2012 in the Thomson Reuters MarketScan database. Current Procedural Terminology coding at inpatient visit was used to select for meningioma resection procedure. Comorbidities and complications were obtained by use of the International Classification of Diseases, Ninth Revision or Current Procedural Terminology coding. Associations between complications and demographic and clinical factors were evaluated with logistic regression.

Results: We identified a total of 2216 patients. Approximately 41% developed 1 or more perioperative complications. Approximately 15% were readmitted within 30 days of their procedure. The most frequent complications that occurred in our cohort were new postoperative seizures (11.8%), postoperative dysrhythmia (7.9%), intracranial hemorrhage (5.9%), and cerebral artery occlusion (5.4%). General neurosurgical complications and general neurologic complications occurred in 4.4% and 16.1% of patients, respectively. Nearly 55% of elderly patients (≥ 70 years) developed 1 or more perioperative complication (vs. 39% of nonelderly patients). After we adjusted for comorbidities, elderly status and male sex were found to be significantly associated with increased odds for a variety of complications.

Conclusions: In this study, we report complication rates in patients undergoing resection for meningioma. Because of the longitudinal nature of the MarketScan database, we were able to capture a wide array of specific postoperative complications associated with meningioma resection procedures. Care should be taken in the selection of candidates for meningioma resection.

Keywords: Adverse events; Craniotomy; MarketScan; Meningioma.

MeSH terms

  • Adult
  • Age Distribution
  • Age Factors
  • Aged
  • Arrhythmias, Cardiac / etiology
  • Arterial Occlusive Diseases / etiology
  • Cerebral Arteries / pathology
  • Craniotomy / adverse effects
  • Databases, Factual
  • Female
  • Humans
  • Intracranial Hemorrhages / etiology
  • Logistic Models
  • Male
  • Meningeal Neoplasms / surgery*
  • Meningioma / surgery*
  • Middle Aged
  • Neurosurgical Procedures / adverse effects*
  • Seizures / etiology
  • Sex Factors
  • United States