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07.05.2024 | Research

Frailty in intracranial meningioma resection: the risk analysis index demonstrates strong discrimination for predicting non-home discharge and in-hospital mortality

verfasst von: Michael M. Covell, Joanna M. Roy, Nithin Gupta, Ahmed Sami Raihane, Kranti C. Rumalla, Amanda Cyntia Lima Fonseca Rodrigues, Evan Courville, Christian A. Bowers

Erschienen in: Journal of Neuro-Oncology

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Abstract

Purpose

Frailty is an independent risk factor for adverse postoperative outcomes following intracranial meningioma resection (IMR). The role of the Risk Analysis Index (RAI) in predicting postoperative outcomes following IMR is nascent but may inform preoperative patient selection and surgical planning.

Methods

IMR patients from the Nationwide Inpatient Sample were identified using diagnostic and procedural codes (2019–2020). The relationship between preoperative RAI-measured frailty and primary outcomes (non-home discharge (NHD), in-hospital mortality) and secondary outcomes (extended length of stay (eLOS), complication rates) was assessed via multivariate analyses. The discriminatory accuracy of the RAI for primary outcomes was measured in area under the receiver operating characteristic (AUROC) curve analysis.

Results

A total of 23,230 IMR patients (mean age = 59) were identified, with frailty statuses stratified by RAI score: 0–20 “robust” (R)(N = 10,665, 45.9%), 21–30 “normal” (N)(N = 8,895, 38.3%), 31–40 “frail” (F)(N = 2,605, 11.2%), and 41+ “very frail” (VF)(N = 1,065, 4.6%). Rates of NHD (R 11.5%, N 29.7%, F 60.8%, VF 61.5%), in-hospital mortality (R 0.5%, N 1.8%, F 3.8%, VF 7.0%), eLOS (R 13.2%, N 21.5%, F 40.9%, VF 46.0%), and complications (R 7.5%, N 11.6%, F 15.7%, VF 16.0%) significantly increased with increasing frailty thresholds (p < 0.001). The RAI demonstrated strong discrimination for NHD (C-statistic: 0.755) and in-hospital mortality (C-statistic: 0.754) in AUROC curve analysis.

Conclusion

Increasing RAI-measured frailty is significantly associated with increased complication rates, eLOS, NHD, and in-hospital mortality following IMR. The RAI demonstrates strong discrimination for predicting NHD and in-hospital mortality following IMR, and may aid in preoperative risk stratification.

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Titel: Frailty in intracranial meningioma resection: the risk analysis index demonstrates strong discrimination for predicting non-home discharge and in-hospital mortality
verfasst von: Michael M. Covell
Joanna M. Roy
Nithin Gupta
Ahmed Sami Raihane
Kranti C. Rumalla
Amanda Cyntia Lima Fonseca Rodrigues
Evan Courville
Christian A. Bowers
Publikationsdatum: 07.05.2024
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-024-04703-5

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