• Naoyuki Isobe, Fusao Ikawa, Atsushi Tominaga, Kazuhiko Kuroki, Takashi Sadatomo, Tatsuya Mizoue, Osamu Hamasaki, Toshinori Matsushige, Masaru Abiko, Takafumi Mitsuhara, Yasuyuki Kinoshita, Masaaki Takeda, and Kaoru Kurisu.
• Department of Neurosurgery, JA Onomichi General Hospital, Onomichi, Hiroshima, Japan.
• World Neurosurg. 2018 Nov 1; 119: e167-e173.

BackgroundOlder patients are increasingly presenting for surgery with intracranial meningioma because of progress with diagnostic imaging and longer life expectancy. However, older patients have many problems, such as comorbidities and reduced physiological capacity reflected in the frailty index. This study examines the factors affecting clinical deterioration after surgery in older patients, particularly factors associated with frailty.MethodsTwo hundred sixty-five patients older than 65 years underwent surgical resection of meningioma at Hiroshima University and related hospitals between 2000 and 2016. Karnofsky Performance Status (KPS) scores before and after surgery were evaluated. Factors related to the deterioration of KPS were analyzed with multivariate logistic regression modeling, including body mass index and serum albumin.ResultsKPS score deteriorated compared with preoperative score in 56 patients at discharge and in 40 patients at 3 months later, and 2 patients died within 1 year after surgery. Multivariate logistic regression analysis in addition to preoperative body mass index and serum albumin indicated skull base tumor location (odds ratio [OR], 4.67; 95% confidence interval [CI], 2.02-10.8) and serum albumin (OR, 2.38; 95% CI, 1.06-5.34) were risk factors for deterioration of KPS score at discharge. Age (OR, 0.91; 95% CI, 0.85-0.98), skull base tumor location (OR, 4.32; 95% CI, 1.45-12.9), tumor size (OR, 1.03; 95% CI, 1.00-1.05), and serum albumin (OR, 3.53; 95% CI, 1.29-9.61) were significant risk factors for perioperative intracranial complications.ConclusionsSkull base tumor location and serum albumin correlated with deterioration of clinical status after surgery.Copyright © 2018 Elsevier Inc. All rights reserved.

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