Clinical neurology and neurosurgery · 2025
The social deprivation index and perioperative outcomes following meningioma resection.
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Ebada Ali, Shukla Ishav Y, Bever Nicholas, Sun Matthew Z
Аннотация
INTRODUCTION: The Social Deprivation Index (SDI) is a validated measure of neighborhood-level socioeconomic disadvantage. Its impact on perioperative outcomes following meningioma resection remains underexplored.
METHODS: We retrospectively analyzed patients who underwent intracranial meningioma resection at a single tertiary academic institution from 2011 to 2023, stratified by SDI quartile (Q1 to Q4). Outcomes included baseline characteristics, operative parameters, complications, readmissions, and functional status.
RESULTS: In our analysis of 887 patients, we found that higher SDI quartiles had greater comorbidity burden, with hypertension, COPD, and obesity more prevalent, as well as higher rates of non-White race and Hispanic ethnicity. The total number of comorbidities increased progressively from Q1 to Q4 (p = 0.001). Tumor grade, volume, and operative time were generally similar across quartiles, but ASA class III-IV status was more common in Q4 (p = 0.002), and skull base tumors were more frequent in higher quartiles (p = 0.010). Multivariable regression revealed that patients in Q2 and Q4 had significantly longer operative times compared to Q1 (p = 0.018; p = 0.031). Functional outcomes demonstrated an unexpected finding: patients in Q3 showed greater improvement in postoperative mRS compared to Q1 (p = 0.010). No significant differences were found in change in KPS, EBL, LOS, or hospital charges. On univariable and multivariable logistic regression, Q4 patients had significantly increased odds of non-neurological complications compared to Q1 (p = 0.016). In contrast, neurological complications and 30-, 60-, and 90-day readmissions did not differ significantly across quartiles.
CONCLUSION: SDI quartile was associated with comorbidity burden, ASA class, skull base tumor location, operative time, and risk of non-neurological complications after meningioma resection. SDI may serve as a prognostic marker to help identify vulnerable patients, guide perioperative planning, and improve recovery counseling after meningioma resection.
METHODS: We retrospectively analyzed patients who underwent intracranial meningioma resection at a single tertiary academic institution from 2011 to 2023, stratified by SDI quartile (Q1 to Q4). Outcomes included baseline characteristics, operative parameters, complications, readmissions, and functional status.
RESULTS: In our analysis of 887 patients, we found that higher SDI quartiles had greater comorbidity burden, with hypertension, COPD, and obesity more prevalent, as well as higher rates of non-White race and Hispanic ethnicity. The total number of comorbidities increased progressively from Q1 to Q4 (p = 0.001). Tumor grade, volume, and operative time were generally similar across quartiles, but ASA class III-IV status was more common in Q4 (p = 0.002), and skull base tumors were more frequent in higher quartiles (p = 0.010). Multivariable regression revealed that patients in Q2 and Q4 had significantly longer operative times compared to Q1 (p = 0.018; p = 0.031). Functional outcomes demonstrated an unexpected finding: patients in Q3 showed greater improvement in postoperative mRS compared to Q1 (p = 0.010). No significant differences were found in change in KPS, EBL, LOS, or hospital charges. On univariable and multivariable logistic regression, Q4 patients had significantly increased odds of non-neurological complications compared to Q1 (p = 0.016). In contrast, neurological complications and 30-, 60-, and 90-day readmissions did not differ significantly across quartiles.
CONCLUSION: SDI quartile was associated with comorbidity burden, ASA class, skull base tumor location, operative time, and risk of non-neurological complications after meningioma resection. SDI may serve as a prognostic marker to help identify vulnerable patients, guide perioperative planning, and improve recovery counseling after meningioma resection.