scholarly journals Association between postoperative hypoalbuminemia and postoperative pulmonary imaging abnormalities patients undergoing craniotomy for brain tumors: a retrospective cohort study

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Da-wei Zhao ◽  
Feng-chun Zhao ◽  
Xu-yang Zhang ◽  
Kai-yan Wei ◽  
Yi-bin Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Operation Time ◽  
Tumor Surgery ◽  
Regression Analyses ◽  
Brain Tumor Surgery ◽  
Pulmonary Imaging ◽  
The Impact ◽  
Preoperative Albumin

AbstractHypoalbuminemia is associated with poor outcome in patients undergoing surgery intervention. The main aim for this study was to investigate the incidence and the risk factors of postoperative hypoalbuminemia and assessed the impact of postoperative hypoalbuminemia on complications in patients undergoing brain tumor surgery. This retrospective study included 372 consecutive patients who underwent brain tumors surgery from January 2017 to December 2019. The patients were divided into hypoalbuminemia (< 35 g/L) and non-hypoalbuminemia group (≥ 35 g/L) based on postoperative albumin levels. Logistic regression analyses were used to determine risk factors. Of the total 372 patients, 333 (89.5%) developed hypoalbuminemia after surgery. Hypoalbuminemia was associated with operation time (OR 1.011, P < 0.001), preoperative albumin (OR 0.864, P = 0.015) and peroperative globulin (OR 1.192, P = 0.004). Postoperative pulmonary imaging abnormalities had a higher incidence in patients with than without hypoalbuminemia (41.1% vs 23.1%, P = 0.029). The independent predictors of postoperative pulmonary imaging abnormalities were age (OR 1.053, P < 0.001), operation time (OR 1.003, P = 0.013) and lower postoperative albumin (OR 0.946, P = 0.018). Pulmonary imaging abnormalities [OR 19.862 (95% CI 2.546–154.936, P = 0.004)] was a novel independent predictors of postoperative pneumonia. Postoperative hypoalbuminemia has a higher incidence with the increase of operation time, and may be associated with postoperative complications in patients undergoing brain tumor surgery.

scholarly journals Postoperative Hypoalbuminemia: Prevalence, Risk Factors, Association with Postoperative Pneumonia in Brain Tumors Patients Undergoing Craniotomy

2021 ◽  
Author(s):  
Da-wei Zhao ◽  
Xu-yang Zhang ◽  
Kai-yan Wei ◽  
Yi-bin Jiang ◽  
Dan Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Operation Time ◽  
Postoperative Pneumonia ◽  
Tumor Surgery ◽  
Regression Analyses ◽  
Brain Tumor Surgery ◽  
The Impact ◽  
Preoperative Albumin

Abstract Hypoalbuminemia is associatied with poor outcome in patients undergoing surgery intervention. The main aim for this study was to investigate the incidence and the risk factors of postoperative hypoalbuminemia and assessed the impact of postoperative hypoalbuminemia on complications in patients undergoing brain tumor surgery. This retrospective study included 372 consecutive patients who underwent brain tumors surgery from January 2017 to December 2019. The patients were divided into hypoalbuminemia (< 35 g/L) and non-hypoalbuminemia group (≥ 35 g/L) based on postoperative albumin levels. Logistic regression analyses were used to determine risk factors. Of the total 372 patients, 333 (89.5%) developed hypoalbuminemia after surgery. Hypoalbuminemia was associated with operation time (OR 1.011, P < 0.001), preoperative albumin (OR 0.864, P = 0.015) and peroperative globulin (OR 1.192, P = 0.004). Postoperative pneumonia had a higher incidence in patients with than without hypoalbuminemia (41.1% vs 23.1%, P = 0.029). The independent predictors of postoperative pneumonia were age (OR 1.053, P < 0.001), operation time (OR 1.003, P = 0.013) and lower postoperative albumin (OR 0.946, P = 0.018). Postoperative hypoalbuminemia has a higher incidence with the increase of operation time, and is associated with postoperative pneumonia in patients undergoing brain tumor surgery.

scholarly journals Postoperative Hypoalbuminemia: Prevalence, Risk Factors, Association with Postoperative Pneumonia in Brain Tumors Patients Undergoing Craniotomy

2021 ◽  
Author(s):  
Da-wei Zhao ◽  
Xu-yang Zhang ◽  
Kai-yan Wei ◽  
Yi-bin Jiang ◽  
Dan Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Tumor ◽  
Postoperative Complications ◽  
Brain Tumors ◽  
Demographic Data ◽  
Operation Time ◽  
Postoperative Pneumonia ◽  
Postoperative Serum ◽  
The Impact ◽  
Preoperative Albumin

Abstract Purpose Hypoalbuminemia is associatied with to poor outcome in patients undergoing surgery intervention. The main aim for this study was to investigate the incidence and the risk factors of postoperative hypoalbuminemia and assessed the impact of postoperative hypoalbuminemia on postoperative complications in patients undergoing brain tumor surgery. Methods This retrospective study included 372 consecutive patients who underwent craniotomy for brain tumors from January 2017 to December 2019. The demographic data, pre- and post-operative laboratory tests and postoperative complications were collected. The patients were divided into two groups based on the postoperative serum albumin levels; hypoalbuminemia group (< 35 g/L) and non-hypoalbuminemia group (≥ 35 g/L). Univariate and multivariate logistic regression analyses were used to determine risk factors of postoperative hypoalbuminemia and complications. Results Of the total 372 patients underwent craniotomy due to brain tumor, 333 patients (89.5%) developed hypoalbuminemia after surgery. Hypoalbuminemia was associated with operation time (OR 1.011, P < 0.001), preoperative albumin (OR 0.864, P = 0.015) and peroperative globulin (OR 1.192, P = 0.004). The incidence of postoperative pneumonia in patients with hypoalbuminemia (41.1%) significantly higher than that in patients without hypoalbuminemia (23.1%) (P = 0.029). The independent predictors of postoperative pneumonia were age (OR 1.053, P < 0.001), operation time (OR 1.003, P = 0.013) and lower postoperative albumin (OR 0.946, P = 0.018). Conclusions Postoperative hypoalbuminemia has a higher incidence with the increase of operation time, and is associated with postoperative pneumonia in patients underwent craniotomy due brain tumor.

Suicidal ideation in patients undergoing brain tumor surgery: prevalence and risk factors

2016 ◽  
Author(s):  
Aiste Pranckeviciene ◽  
Sarunas Tamasauskas ◽  
Vytenis Pranas Deltuva ◽  
Robertas Bunevicius ◽  
Arimantas Tamasauskas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Tumor ◽  
Suicidal Ideation ◽  
Tumor Surgery ◽  
Brain Tumor Surgery

scholarly journals Effect of hemostasis and electrosurgery on the development and evolution of brain tumor surgery in the late 19th and early 20th centuries

2005 ◽  
Vol 18 (4) ◽  
pp. 1-7 ◽  
Author(s):  
John R. Vender ◽  
Jason Miller ◽  
Andy Rekito ◽  
Dennis E. McDonnell
Keyword(s):  
Brain Tumor ◽  
Brain Tissue ◽  
Surgical Management ◽  
Tumor Surgery ◽  
Brain Tumor Surgery ◽  
The Impact ◽  
Neurological Surgeon ◽  
The Brain ◽  
Development And Evolution ◽  
Type Of Surgery

Hemostatic options available to the surgeon in the late 19th and early 20th centuries were limited. The surgical ligature was limited in value to the neurological surgeon because of the unique structural composition of brain tissue as well as the approaches and operating angles used in this type of surgery. In this manuscript the authors review the options available and the evolution of surgical hemostatic techniques and electrosurgery in the late 19th and early 20th centuries and the impact of these methods on the surgical management of tumors of the brain and its coverings.

scholarly journals New Hope in Brain Glioma Surgery: The Role of Intraoperative Ultrasound. A Review

2018 ◽  
Vol 8 (11) ◽  
pp. 202 ◽  
Author(s):  
Maria Pino ◽  
Alessia Imperato ◽  
Irene Musca ◽  
Rosario Maugeri ◽  
Giuseppe Giammalva ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Low Cost ◽  
Tumor Resection ◽  
Intraoperative Ultrasound ◽  
Tumor Surgery ◽  
Brain Tumor Surgery ◽  
Glioma Surgery ◽  
Pubmed Database

Maximal safe resection represents the gold standard for surgery of malignant brain tumors. As regards gross-total resection, accurate localization and precise delineation of the tumor margins are required. Intraoperative diagnostic imaging (Intra-Operative Magnetic Resonance-IOMR, Intra-Operative Computed Tomography-IOCT, Intra-Operative Ultrasound-IOUS) and dyes (fluorescence) have become relevant in brain tumor surgery, allowing for a more radical and safer tumor resection. IOUS guidance for brain tumor surgery is accurate in distinguishing tumor from normal parenchyma, and it allows a real-time intraoperative visualization. We aim to evaluate the role of IOUS in gliomas surgery and to outline specific strategies to maximize its efficacy. We performed a literature research through the Pubmed database by selecting each article which was focused on the use of IOUS in brain tumor surgery, and in particular in glioma surgery, published in the last 15 years (from 2003 to 2018). We selected 39 papers concerning the use of IOUS in brain tumor surgery, including gliomas. IOUS exerts a notable attraction due to its low cost, minimal interruption of the operational flow, and lack of radiation exposure. Our literature review shows that increasing the use of ultrasound in brain tumors allows more radical resections, thus giving rise to increases in survival.

387 Ischemic Preconditioning Reduces the Incidence of Postoperative Ischemic Lesions in Patients Undergoing Surgical Resection of Brain Tumors: A Single Center, Randomized, Double-blind, Controlled Trial

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 292-293
Author(s):  
Arthur H A Sales ◽  
Melanie Barz ◽  
Stefanie Bette ◽  
Benedikt Wiestler ◽  
Yu-Mi Ryang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Ischemic Preconditioning ◽  
Control Group ◽  
Tumor Surgery ◽  
Brain Tumor Surgery ◽  
Blood Pressure Cuff ◽  
Pressure Cuff ◽  
Ischemic Tissue

Abstract INTRODUCTION Postoperative ischemia is a frequent phenomenon in patients with brain tumors and is associated with postoperative neurological deficits and impaired overall survival. Previous clinical and experimental studies have shown that the application of a brief ischemic stimulus not only in the target organ but also in a remote tissue can prevent ischemia. We hypothesized that remote ischemic preconditioning (rIPC) in patients with brain tumors undergoing elective surgical resection reduces the incidence of postoperative ischemic tissue damage and its consequences. METHODS Sixty patients were randomly assigned to two groups, with 1:1 allocation, stratified after tumor type (glioma or metastasis) and previous treatment with radiotherapy. Remote ischemic preconditioning was induced by inflating a blood pressure cuff placed on the upper arm three times for 5 minutes at 200 mmHg in the treatment group after induction of anesthesia. Between the cycles, the blood pressure cuff was released to allow reperfusion. In the control group no preconditioning was performed. Early postoperative MR images were evaluated blinded to randomization for the presence of ischemia and its volume. RESULTS >Fifty-eight of the 60 patients were assessed for occurrence of postoperative ischemia. Of these 58 patients, 44 (75.9%) had new postoperative ischemic lesions. The incidence of new postoperative ischemic lesions was significantly higher in the control group (87.1%) (27/31) than in the rIPC group (63.0%) (17/27) (P = 0.03). The median infarct volume was 0.36 cm3 (IR: 0.0- 2.35) in the rIPC group compared with 1.30 cm3 (IR: 0.29- 3.66) in the control group (P = 0.09). CONCLUSION Application of rIPC significantly reduced the incidence of postoperative ischemic tissue damage in patients undergoing elective brain tumor surgery. This is the first study indicating a benefit of rIPC in brain tumor surgery.

scholarly journals The Impact of Hospital Safety-Net Burden on Outcomes for Primary Supratentorial Brain Tumor Surgery

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Oliver Young Tang ◽  
Anna Kimata ◽  
Steven A Toms
Keyword(s):  
Brain Tumor ◽  
Length Of Stay ◽  
Severity Of Illness ◽  
Safety Net ◽  
Public Hospitals ◽  
Neurosurgical Procedures ◽  
Tumor Surgery ◽  
Brain Tumor Surgery ◽  
Hospital Safety ◽  
The Impact

Abstract INTRODUCTION Safety-net hospitals treat a disproportionate share of vulnerable patient populations. While outcomes at these institutions for neurosurgical procedures, such as cerebral aneurysm surgery, have been researched, the impact of safety-net burden on brain tumor surgery is poorly characterized. METHODS Using International Classification of Diseases-9 diagnosis codes, we identified all adult admissions in the National Inpatient Sample from 2002 to 2011 undergoing craniotomy for a primary supratentorial brain tumor (191.0-5, 191.8-9, 225.0 and 237.5), excluding patients with brain metastasis (198.3). For each hospital, we quantified safety-net burden as the percentage of patients on Medicaid or without insurance. Hospitals in the top quartile of safety-net burden were categorized as high-burden hospitals (HBHs) while the remainder were low-burden hospitals (LBHs). Survey-weighted multivariate regression was used to make national estimates and adjust for 12 confounding variables: age, sex, insurance, household income, severity of illness and risk of mortality scores, Charlson Comorbidity Index, malignant status, hospital ownership, teaching status, region, and volume. RESULTS We analyzed 162 828 total admissions admitted to 1135 hospitals for brain tumor craniotomy in 2002 to 2011. A total of 212 hospitals (19%) were classified as HBHs, treating 16 914 admissions. HBHs were more likely to be low-volume and public hospitals (both P < .001). Moreover, patients at HBHs were less likely to be white and had higher severity of illness scores (both P < .001). When evaluating outcomes, hospital safety-net status was not associated with mortality (P = .260), favorable discharge disposition (P = .765), or perioperative complications (P = .757). However, admission to HBHs was associated with higher length of stay (+ 0.74 d, P = .007) and inpatient costs (+ $2 448, P = .002). CONCLUSION Although safety-net burden was not associated with mortality, disposition, or complications, patients at safety-net hospitals exhibited increased length of stay and costs, potentially due to factors like resource limitations or more advanced disease presentation among safety-net patients. Amidst potential reforms like “pay-for-performance” reimbursement models, it is critical to further study neurosurgical outcomes at safety-net hospitals.

scholarly journals Improving the accuracy of brain tumor surgery via Raman-based technology

2016 ◽  
Vol 40 (3) ◽  
pp. E9 ◽  
Author(s):  
Todd Hollon ◽  
Spencer Lewis ◽  
Christian W. Freudiger ◽  
X. Sunney Xie ◽  
Daniel A. Orringer
Keyword(s):  
Raman Spectroscopy ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Real Time ◽  
Surgical Management ◽  
Residual Tumor ◽  
Normal Brain ◽  
Tumor Surgery ◽  
Brain Tumor Surgery ◽  
Perfect Agreement

Despite advances in the surgical management of brain tumors, achieving optimal surgical results and identification of tumor remains a challenge. Raman spectroscopy, a laser-based technique that can be used to nondestructively differentiate molecules based on the inelastic scattering of light, is being applied toward improving the accuracy of brain tumor surgery. Here, the authors systematically review the application of Raman spectroscopy for guidance during brain tumor surgery. Raman spectroscopy can differentiate normal brain from necrotic and vital glioma tissue in human specimens based on chemical differences, and has recently been shown to differentiate tumor-infiltrated tissues from noninfiltrated tissues during surgery. Raman spectroscopy also forms the basis for coherent Raman scattering (CRS) microscopy, a technique that amplifies spontaneous Raman signals by 10,000-fold, enabling real-time histological imaging without the need for tissue processing, sectioning, or staining. The authors review the relevant basic and translational studies on CRS microscopy as a means of providing real-time intraoperative guidance. Recent studies have demonstrated how CRS can be used to differentiate tumor-infiltrated tissues from noninfiltrated tissues and that it has excellent agreement with traditional histology. Under simulated operative conditions, CRS has been shown to identify tumor margins that would be undetectable using standard bright-field microscopy. In addition, CRS microscopy has been shown to detect tumor in human surgical specimens with near-perfect agreement to standard H & E microscopy. The authors suggest that as the intraoperative application and instrumentation for Raman spectroscopy and imaging matures, it will become an essential component in the neurosurgical armamentarium for identifying residual tumor and improving the surgical management of brain tumors.

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