Analysis of Morbidity and Mortality in Posterior Fossa/Cerebellar Pontine Angle Meningioma Resections 2012–2016

Introduction: We analyzed perioperative risk factors for morbidity and mortality for the patients undergoing surgical intervention for posterior fossa/cerebellar pontine angle meningiomas along with rates of reoperations and cerebrospinal fluid leaks that required surgery.

Materials and Methods: Patients undergoing craniotomy or craniectomy for posterior fossa meningiomas were identified in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2012 to 2016 using CPT codes for posterior fossa surgical approaches and ICD9 and ICD10 codes for tumors of the meninges. Preoperative laboratories, comorbidities, and operative times were analyzed along with cerebrospinal fluid leaks and unplanned returns to the operating room.

Results: A total of 942 patients who underwent surgery for posterior fossa or cerebellar pontine angle meningiomas were identified, 7 were excluded because they lacked basic demographic data and preoperative comorbidities. Average age was 56, and 76% were female. Mortality within 30 days of the operation was very low at 1.2%, nonneurological complications were 13% with cerebrovascular accidents being the most common at 3.1%, and unplanned reoperations happened in 7% percent of the cases. Significant predictors of 30 day complications was duration of surgery longer than 6.5 hours (OR: 2.0, 95% CI: 1.03–4.13, p = 0.04) and history of COPD (OR: 6.1, 95% CI: 1.13–32.3, p = 0.04). The only significant predictor of mortality within 30 days of surgery was age over 70 years old (OR: 7.4, 95% CI: 1.96–28.2, p = 0.003). There were no significant predictors for unplanned return to the operating room that could be identified. Most of the returns were for ventriculoperitoneal shunt placement, 10% of the reoperations, the rest were for variety of other surgeries. CSF leak complicated 0.74% of the cases and curiously was much lower than in operations for vestibular schwannoma resection outlined in our other abstract.

Conclusion: Duration of surgery over 6.5 hours and history of COPD preoperatively are the greatest predictors of complications, while age over 70 is a significant predictor of mortality in the 30-day postoperative period for patients undergoing a posterior fossa meningioma resection.

No conflict of interest has been declared by the author(s).