Association between disseminated cancer and postoperative 30-day mortality in adult patients with brain tumor craniotomy

Yufei Liu¹Ke Cao²Rui He¹Wenjian Zheng¹Zongyang Li¹Xuanchen Li¹Mengqi Wang¹Haofei Hu^3*Guodong Huang^1*

• ¹Department of Neurosurgery, Shenzhen Second People's Hospital, Shenzhen, China
• ²Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
• ³Department of Nephrology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China

Abstract Background: Quantitative evidence on the association between disseminated cancer (DC) and 30-day postoperative mortality after tumor resection craniotomy in adults is limited. This study evaluates the association between them. Materials and Methods: This retrospective analysis utilized propensity score matching (PSM) on cases extracted from the American College of Surgeons National Surgical Quality Improvement Program database (2012-2015). The study examined DC as the independent variable and 30-day postoperative mortality as the dependent outcome. A logistic regression analysis was conducted on the PSM data that were 1:1 matched. The DC-mortality association was assessed using robust statistical estimation methods. Results: The study cohort comprised 18,642 eligible patients (52.6% male, 47.4% female), including 4,022 (21.57%) with DC. The mortality rate was significantly higher in DC patients (4.97%) compared to the overall cohort undergoing tumor-related craniotomy (2.46%). Multivariate analysis and propensity score-adjusted analysis demonstrated that, compared with non-DC, the postoperative 30-day mortality of patients with DC undergoing craniotomy for brain tumors significantly increased, with associated odds ratios of 1.72 to 2.06. Conclusion: Given the relatively high risk of mortality within 30 days after craniotomy in patients with DC, both preoperative surgical decision-making and postoperative management strategies should be appropriately modified to reduce mortality.