World neurosurgery · 2026
National Outcomes and Factors Associated with 30-Day Mortality in Malignant Brain Tumor Surgery: A Retrospective Cohort National Surgical Quality Improvement Program Analysis of Health System Resilience.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Nguyen Anthony V, Coughlin Emily, Mhaskar Rahul, Soto Jose M
Аннотация
OBJECTIVE: This study investigates whether the incidence of 30-day postoperative mortality following supratentorial primary malignant brain tumor surgery differed significantly during the COVID-19 pandemic (2020-2021) compared to the prepandemic era (2016-2019).
METHODS: This retrospective cohort study used the National Surgical Quality Improvement Program database to identify adult patients who underwent craniotomy for supratentorial primary malignant brain tumor resection. We compared 30-day mortality rates and analyzed risk factors associated with mortality in both periods using univariable and multivariable logistic regression.
RESULTS: The study included 13,716 patients (8830 prepandemic; 4886 during the pandemic). Overall 30-day mortality rates were 3.1% prepandemic and 2.6% during the pandemic (P = 0.087). Multivariable analysis identified time period, age, disseminated cancer, increased preoperative white blood cell count, and postoperative complications (pneumonia, ventilation > 48 hours, and stroke/cerebrovascular accident) as factors significantly associated with mortality. Despite an expected increased odds of mortality during the COVID-19 period, surgery during the pandemic was associated with lower odds of mortality (odds ratio: 0.70, 95% confidence interval: 0.55-0.88, P = 0.0027) in multivariable logistic regression.
CONCLUSIONS: Contrary to our hypothesis, 30-day mortality was lower during the COVID-19 pandemic. Patient-specific factors and postoperative complications remain the primary drivers of mortality regardless of the healthcare era. These results highlight the importance of perioperative risk mitigation and provide hypothesis-generating data for understanding how neurosurgical care can be maintained during periods of high demand that stress the healthcare system to its capacity.
METHODS: This retrospective cohort study used the National Surgical Quality Improvement Program database to identify adult patients who underwent craniotomy for supratentorial primary malignant brain tumor resection. We compared 30-day mortality rates and analyzed risk factors associated with mortality in both periods using univariable and multivariable logistic regression.
RESULTS: The study included 13,716 patients (8830 prepandemic; 4886 during the pandemic). Overall 30-day mortality rates were 3.1% prepandemic and 2.6% during the pandemic (P = 0.087). Multivariable analysis identified time period, age, disseminated cancer, increased preoperative white blood cell count, and postoperative complications (pneumonia, ventilation > 48 hours, and stroke/cerebrovascular accident) as factors significantly associated with mortality. Despite an expected increased odds of mortality during the COVID-19 period, surgery during the pandemic was associated with lower odds of mortality (odds ratio: 0.70, 95% confidence interval: 0.55-0.88, P = 0.0027) in multivariable logistic regression.
CONCLUSIONS: Contrary to our hypothesis, 30-day mortality was lower during the COVID-19 pandemic. Patient-specific factors and postoperative complications remain the primary drivers of mortality regardless of the healthcare era. These results highlight the importance of perioperative risk mitigation and provide hypothesis-generating data for understanding how neurosurgical care can be maintained during periods of high demand that stress the healthcare system to its capacity.