Journal Home > Volume 7 , Issue 3
Objective:

The objective of this study was to document the impact of the preoperative Karnofsky Performance Scale (KPS) and American Society of Anesthesiologists (ASA) scores on perioperative complications in patients with recurrent glioma who underwent tumor resection via craniotomy.

Methods:

A total of 96 patients were retrospectively reviewed. Based on KPS and ASA scores, patients were categorized into high KPS (> 70) or low KPS (≤ 70) and high ASA (3~4) or low ASA (1~2) groups. Differences in intraoperative risk factors and perioperative complications among the groups were analyzed. Multivariate analysis was performed to identify risk factors for perioperative complications.

Results:

The most frequent perioperative complications were cerebrospinal fluid leakage (31.8%) and intracranial infection (27.0%); 30-day mortality was 5.2%. The incidence rates of severe complications, central nervous system complications, and total complications were comparable in the low and high KPS groups and in the low and high ASA groups (all p > 0.05). Multivariate analysis showed that low KPS and high ASA scores were not the independent risk factors for perioperative complications.

Conclusion:

Low KPS and high ASA scores are not associated with increased postoperative complications in patients with recurrent glioma who undergo tumor resection via craniotomy.


menu
Abstract
Full text
Outline
About this article

Impact of preoperative Karnofsky Performance Scale (KPS) and American Society of Anesthesiologists (ASA) scores on perioperative complications in patients with recurrent glioma undergoing repeated operation

Show Author's information Zhong Deng1,2Hai Yu1,2Ning Wang1Wahap Alafate1,2Jia Wang1Tuo Wang1Changwang Du1( )Maode Wang1( )
Department of Neurosurgery, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi, China
School of Medicine, Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China

Abstract

Objective:

The objective of this study was to document the impact of the preoperative Karnofsky Performance Scale (KPS) and American Society of Anesthesiologists (ASA) scores on perioperative complications in patients with recurrent glioma who underwent tumor resection via craniotomy.

Methods:

A total of 96 patients were retrospectively reviewed. Based on KPS and ASA scores, patients were categorized into high KPS (> 70) or low KPS (≤ 70) and high ASA (3~4) or low ASA (1~2) groups. Differences in intraoperative risk factors and perioperative complications among the groups were analyzed. Multivariate analysis was performed to identify risk factors for perioperative complications.

Results:

The most frequent perioperative complications were cerebrospinal fluid leakage (31.8%) and intracranial infection (27.0%); 30-day mortality was 5.2%. The incidence rates of severe complications, central nervous system complications, and total complications were comparable in the low and high KPS groups and in the low and high ASA groups (all p > 0.05). Multivariate analysis showed that low KPS and high ASA scores were not the independent risk factors for perioperative complications.

Conclusion:

Low KPS and high ASA scores are not associated with increased postoperative complications in patients with recurrent glioma who undergo tumor resection via craniotomy.

Keywords: complications, repeated craniotomy, glioma, Karnofsky Performance Scale (KPS) score, American Society of Anesthesiologists (ASA) score

References(21)

[1]
KA McNeill. Epidemiology of brain tumors. Neurol Clin. 2016, 34(4): 981-998.
[2]
JM Hoover, M Nwojo, R Puffer, et al. Surgical outcomes in recurrent glioma: clinical article. J Neurosurg. 2013, 118(6): 1224-1231.
[3]
SL Hervey-Jumper, MS Berger. Reoperation for recurrent high-grade glioma: a current perspective of the literature. Neurosurgery. 2014, 75(5): 491-499.
[4]
C Jackson, M Westphal, A Quiñones-Hinojosa. Complications of glioma surgery. Handb Clin Neurol. 2016, 134: 201-218.
[5]
ER Laws, IF Parney, W Huang, et al. Survival following surgery and prognostic factors for recently diagnosed malignant glioma: data from the Glioma Outcomes Project. J Neurosurg. 2003, 99(3): 467-473.
[6]
CG Patil, A Yi, A Elramsisy, et al. Prognosis of patients with multifocal glioblastoma: a case-control study. J Neurosurg. 2012, 117(4): 705-711.
[7]
MI Ruge, J Ilmberger, JC Tonn, et al. Health-related quality of life and cognitive functioning in adult patients with supratentorial WHO grade II glioma: status prior to therapy. J Neurooncol. 2011, 103(1): 129-136.
[8]
LB Chambless, HM Kistka, SL Parker, et al. The relative value of postoperative versus preoperative Karnofsky Performance Scale scores as a predictor of survival after surgical resection of glioblastoma multiforme. J Neurooncol. 2015, 121(2): 359-364.
[9]
JKW Gerritsen, L Arends, M Klimek, et al. Impact of intraoperative stimulation mapping on high-grade glioma surgery outcome: a meta-analysis. Acta Neurochir (Wien). 2019, 161(1): 99-107.
[10]
LB Chambless, SL Parker, L Hassam-Malani, et al. Type 2 diabetes mellitus and obesity are independent risk factors for poor outcome in patients with high- grade glioma. J Neurooncol. 2012, 106(2): 383-389.
[11]
RS D’Amico, MB Cloney, AM Sonabend, et al. The safety of surgery in elderly patients with primary and recurrent glioblastoma. World Neurosurg. 2015, 84(4): 913-919.
[12]
HH Dasenbrock, KX Liu, CA Devine, et al. Length of hospital stay after craniotomy for tumor: a national surgical quality improvement program analysis. Neurosurg Focus. 2015, 39(6): E12.
[13]
B Idali, B Lahyat, K Khaleq, et al. Postoperative infection following craniotomy in adults. Med Mal Infect. 2004, 34(5): 221-224.
[14]
BA Sherrod, JM Johnston, BG Rocque. Risk factors for unplanned readmission within 30 days after pediatric neurosurgery: a nationwide analysis of 9799 procedures from the American college of surgeons national surgical quality improvement program. J Neurosurg Pediatr. 2016, 18(3): 350-362.
[15]
A Nunno, Y Li, TA Pieters, et al. Risk factors and associated complications of symptomatic venous thromboembolism in patients with craniotomy for meningioma. World Neurosurg. 2019, 122: e1505-e1510.
[16]
JM Wong, JR Panchmatia, JE Ziewacz, et al. Patterns in neurosurgical adverse events: intracranial neoplasm surgery. Neurosurg Focus. 2012, 33(5): E16.
[17]
E Reponen, M Korja, T Niemi, et al. Preoperative identification of neurosurgery patients with a high risk of in-hospital complications: a prospective cohort of 418 consecutive elective craniotomy patients. J Neurosurg. 2015, 123(3): 594-604.
[18]
E Jiménez-Martínez, G Cuervo, A Hornero, et al. Risk factors for surgical site infection after craniotomy: a prospective cohort study. Antimicrob Resist Infect Control. 2019, 8: 69.
[19]
DN Louis, A Perry, G Reifenberger, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016, 131(6): 803-820.
[20]
AJ Clark, KR Lamborn, NA Butowski, et al. Neurosurgical management and prognosis of patients with glioblastoma that progresses during bevacizumab treatment. Neurosurgery. 2012, 70(2): 361-370.
[21]
HJ Landy, L Feun, JG Schwade, et al. Retreatment of intracranial gliomas. South Med J. 1994, 87(2): 211-214.
Publication history
Copyright
Acknowledgements
Rights and permissions

Publication history

Received: 17 July 2019
Revised: 22 August 2019
Accepted: 17 September 2019
Published: 18 September 2019
Issue date: September 2019

Copyright

© The authors 2019

Acknowledgements

This work was supported by National Natural Science Foundation of China (grant no. 81802502) and the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University, China (No. XJTU1AF-2016-018).

Rights and permissions

This article is published with open access at http://jnr.tsinghuajournals.com

Return