gms | German Medical Science

Objective: Internal complications severely impair the recovery of neurosurgical patients after craniotomy. In this study we examined a large population of patients with different internal complications following elective craniotomy.

Method: We retrospectively screened 1800 patients who had undergone treatment in our department during a five year interval. We then identified patients with relevant thromboembolic, pulmonary or systemic infectious complications postoperatively. We statistically analyzed possible associations between these complications and 1) duration of surgery, 2) age, 3) pre-existing illness, 4) indication for craniotomy and 5) previous craniotomies.

Results: 133 patients (67 female, 66 male, ranging 14-84 years) were identified. Concerning internal disorders, the overall morbidity was 7.4%. We found statistically significant correlations between thromboembolic events and meningeomas, previous craniotomy, duration of surgery and hypertension (p=0.002, 0,032, <0.001 and <0.001, resp.). Severe infections (pneumonia, sepsis) were associated with craniopharyngeomas, age, previous craniotomy and duration of surgery (p=0.029, 0.012, 0.016 and 0.004, resp.). A prolonged stay on the ICU was associated with duration of surgery and hypertension (p=0.002 and p<0.001).

Conclusions: In this study we identified important predictors that help characterize patients at risk for internal complications due to elective neurosurgical procedures in a large population. These correlations should be taken into account when advising patients on craniotomy.