gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Morbidity and mortality of intracranial meningioma surgery in the elderly

Operative Therapie von intrakraniellen Meningeomen im Alter: Morbidität und Mortalität

Meeting Abstract

  • corresponding author Christopher Brenke - Neurochirurgische Universitätsklinik, Knappschafts-Krankenhaus Bochum-Langendreer, Klinikum der Ruhr-Universität Bochum, Bochum
  • M. Engelhardt - Neurochirurgische Universitätsklinik, Knappschafts-Krankenhaus Bochum-Langendreer, Klinikum der Ruhr-Universität Bochum, Bochum
  • W. Folkers - Neurochirurgische Universitätsklinik, Knappschafts-Krankenhaus Bochum-Langendreer, Klinikum der Ruhr-Universität Bochum, Bochum
  • S. Lücke - Neurochirurgische Universitätsklinik, Knappschafts-Krankenhaus Bochum-Langendreer, Klinikum der Ruhr-Universität Bochum, Bochum
  • K. Schmieder - Neurochirurgische Universitätsklinik, Knappschafts-Krankenhaus Bochum-Langendreer, Klinikum der Ruhr-Universität Bochum, Bochum
  • A. G. Harders - Neurochirurgische Universitätsklinik, Knappschafts-Krankenhaus Bochum-Langendreer, Klinikum der Ruhr-Universität Bochum, Bochum

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMI.02.07

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0252.shtml

Published: April 23, 2004

© 2004 Brenke et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective

With increasing life expectancy and the availability of computed tomography and magnetic resonance a large number of intracranial meningiomas are identified in elderly patients. The decision to operate on intracranial meningiomas is influenced by tumour size and location, severity of symptoms and expected risks of the surgical procedure itself. In the literature on meningioma surgery in the eldery perioperative morbidity even more than fifty percent are reported. Considering these reports in times of advanced microneurosurgical techniques, modern anesthetic and intensive care facilities we reviewed our patients treated surgically for intracranial meningiomas.

Methods

Patients data including age, sex, tumour location, comorbidity, ASA classification and complications were retrospectively collected from the files. At a threshold of 65 ys. two groups (A, B) were created and compared concerning comorbidity (more than three concomitant diseases and/or diabetes), surgical (rebleeding, wound infection, CSF leak), medical (systemic complications, i.e. pneumonia, DVT or myocardial infarction) and neurological (increased or new postoperative neurologic deficit) perioperative morbidity and mortality.

Results

Between January 2000 and September 2003 183 patients underwent 194 surgical procedures for intracranial meningiomas. 121 of these patients were younger than 65 ys. (group A, mean age 54,1ys, 33 male, 88 female), 62 were older than 65 ys. (group B, mean age 72,6ys., 27 male, 35 female). In group A 127 procedures were done, in group B 67. Tumour locations were convexity (27,6% vs. 40,3%), falcine or parasagittal (28,3% vs. 20,9%) and skull base (44,1% vs.38,8%). Comorbidity was less in group A (5,7%) than in group B (31,7%). Group A included 8,3% ASA1, 80,2% ASA2 and 11,5% ASA3 patients, Group B 45,2% ASA2 and 54,8% ASA3 patients. Concerning 194 procedures the overall morbidity in group A was 27,6% and in group B 26,9%. Surgical morbidity in group A was 16,5% and 14,9% in group B. Medical morbidity was 1,6% (group A) and 7,5% (group B). Neurological morbidity was 10,2% (group A) and 6,0% (group B). Mortality in group A was 0% and 3% in group B.

Conclusions

Despite the higher comorbidity among patients older than 65ys. the overall morbidity was not increased in these patients. Compared with former studies morbidity and mortality are low. We think that meningioma surgery under modern conditions is safe and therefore justified in the elderly.