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J Neurol Surg A Cent Eur Neurosurg 2023; 84(05): 409-418
DOI: 10.1055/a-1911-8678
Original Article

Can Currently Suggested Quality Indicators Be Transferred to Meningioma Surgery?—A Single-Center Pilot Study

Dorothee C. Spille‡   *
1   Department of Neurosurgery, University Hospital Münster, Münster, Germany
,
Sebastian Lohmann‡   *
1   Department of Neurosurgery, University Hospital Münster, Münster, Germany
,
Michael Schwake 
1   Department of Neurosurgery, University Hospital Münster, Münster, Germany
,
Johannes Spille
3   Department of Oral and Maxillofacial Surgery, Christian Albrechts University, UKSH, Kiel, Germany
,
Samer Zawy Alsofy
2   Department of Neurosurgery, St. Barbara-Hospital, Hamm, Germany
,
Walter Stummer
1   Department of Neurosurgery, University Hospital Münster, Münster, Germany
,
Benjamin Brokinkel‡   *
1   Department of Neurosurgery, University Hospital Münster, Münster, Germany
,
Stephanie Schipmann‡   *
1   Department of Neurosurgery, University Hospital Münster, Münster, Germany
› Author Affiliations Funding None.
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Abstract

Background Risk stratification based on standardized quality measures has become crucial in neurosurgery. Contemporary quality indicators have often been developed for a wide range of neurosurgical procedures collectively. The accuracy of tumor-inherent characteristics of patients diagnosed with meningioma remains questionable. The objective of this study was the analysis of currently applied quality indicators in meningioma surgery and the identification of potential new measures.

Methods Data of 133 patients who were operated on due to intracranial meningiomas were subjected to a retrospective analysis. The primary outcomes of interest were classical quality indicators such as the 30-day readmission, 30-day reoperation, 30-day mortality, 30-day nosocomial infection, and the 30-day surgical site infection rate. Uni- and multivariate analyses were performed. The occurrence of a new postoperative neurologic deficit was analyzed as a potential new quality indicator.

Results The overall unplanned readmission rate was 3.8%; 13 patients were reoperated within 30 days (9.8%). The 30-day nosocomial infection and surgical site infection rates were 6.8 and 1.5%, respectively. A postoperative new neurologic deficit or neurologic deterioration as a currently assessed quality feature was observed in 12 patients (9.2%). The edema volume on preoperative scans proved to have a significant impact on the occurrence of a new postoperative neurologic deficit (p = 0.023).

Conclusions Classical quality indicators in neurosurgery have proved to correlate with considerable deterioration of the patient's health in meningioma surgery and thus should be taken into consideration for application in meningioma patients. The occurrence of a new postoperative neurologic deficit is common and procedure specific. Thus, this should be elucidated for application as a complementary quality indicator in meningioma surgery.

Keywords

meningioma - microsurgery - new neurologic deficit - outcome - quality indicators

* These authors contributed equally.




Publication History

Received: 15 February 2022

Accepted: 21 July 2022

Accepted Manuscript online:
28 July 2022

Article published online:
09 December 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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