TY - JOUR
T1 - Emergency glioma resection but not hours of operation predicts perioperative complications
T2 - A single center study
AU - Deng, Zhong
AU - Wu, Wei
AU - Wang, Ning
AU - Arafat, Wahap
AU - Li, Zhijin
AU - Wang, Jia
AU - Ren, Chunying
AU - Li, Rihui
AU - Wang, Tuo
AU - Du, Changwang
AU - Wang, Maode
N1 - Publisher Copyright:
© 2019 The First Affiliated Hospital of Xi'an Jiaotong University
PY - 2019/7
Y1 - 2019/7
N2 - Objective: Physical and mental status of neurosurgeons may vary with emergency status and hours of operation, which may impact the outcome of patients undergoing surgery. This study aims to clarify the influence of these parameters on outcome after surgery in glioma patients. Patients and methods: A total of 477 nonemergency surgery (NES) and 30 emergency surgery (ES) were enrolled in this study. Using propensity score matching (PSM) analysis, 97 pairs of procedures from NES group were generated and then classified as group M (morning procedures, 8:00 a.m–1:00 p.m) or group A (afternoon or night procedures, 1:00 p.m–8:00 p.m). 30 emergency procedures were classified into group ESa (daytime emergency surgery, 8:00 a.m–6:00 p.m) and group ESb (nighttime surgery procedures, 6:00 p.m–8:00 a.m the next day). Differences in intraoperative risk factors and postoperative complications were analyzed. Results: Postoperative complications, including death within 30 days (p = 0.004), neurological function deficit (p = 0.012), systemic infection (p < 0.001) were significant higher in emergency procedures. Intraoperative risk factors including blood loss (p < 0.001), blood transfusion (p = 0.036) were also higher in emergency procedures than nonemergency procedures, although both procedures had comparable time duration (p = 0.337). By PSM analysis, patients in group M and group A were well matched and no significant difference of intraoperative risk factors and postoperative complications (all p > 0.05) were found. Furthermore, incidence of intraoperative risk factors and postoperative complications were similar in both groups ESa and ESb (all p > 0.05). Conclusion: Emergency glioma resection is a very important risk factors of perioperative mortality and morbidity for patients. However, hours of operation did not necessarily predict postoperative mortality or morbidity, either in emergency or nonemergency glioma resection.
AB - Objective: Physical and mental status of neurosurgeons may vary with emergency status and hours of operation, which may impact the outcome of patients undergoing surgery. This study aims to clarify the influence of these parameters on outcome after surgery in glioma patients. Patients and methods: A total of 477 nonemergency surgery (NES) and 30 emergency surgery (ES) were enrolled in this study. Using propensity score matching (PSM) analysis, 97 pairs of procedures from NES group were generated and then classified as group M (morning procedures, 8:00 a.m–1:00 p.m) or group A (afternoon or night procedures, 1:00 p.m–8:00 p.m). 30 emergency procedures were classified into group ESa (daytime emergency surgery, 8:00 a.m–6:00 p.m) and group ESb (nighttime surgery procedures, 6:00 p.m–8:00 a.m the next day). Differences in intraoperative risk factors and postoperative complications were analyzed. Results: Postoperative complications, including death within 30 days (p = 0.004), neurological function deficit (p = 0.012), systemic infection (p < 0.001) were significant higher in emergency procedures. Intraoperative risk factors including blood loss (p < 0.001), blood transfusion (p = 0.036) were also higher in emergency procedures than nonemergency procedures, although both procedures had comparable time duration (p = 0.337). By PSM analysis, patients in group M and group A were well matched and no significant difference of intraoperative risk factors and postoperative complications (all p > 0.05) were found. Furthermore, incidence of intraoperative risk factors and postoperative complications were similar in both groups ESa and ESb (all p > 0.05). Conclusion: Emergency glioma resection is a very important risk factors of perioperative mortality and morbidity for patients. However, hours of operation did not necessarily predict postoperative mortality or morbidity, either in emergency or nonemergency glioma resection.
KW - Complications
KW - Emergency
KW - Glioma
KW - Hours of operation
KW - Medical errors
KW - Operation
UR - https://www.scopus.com/pages/publications/85064922714
U2 - 10.1016/j.clineuro.2019.04.010
DO - 10.1016/j.clineuro.2019.04.010
M3 - 文章
C2 - 31054423
AN - SCOPUS:85064922714
SN - 0303-8467
VL - 182
SP - 11
EP - 16
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
ER -