Predictors of mortality at 3 months in patients with skull base tumor resections in a low-income setting
ObjectiveGlobally, skull base tumors are among the most challenging tumors to treat and are known for their significant morbidity and mortality. Hence, this study aimed to identify robust associated factors that contribute to mortality of patients following surgical resection for a variety of skull...
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| Format: | Artikel |
| Sprache: | English |
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Frontiers Media S.A.
2024-12-01
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| Schriftenreihe: | Frontiers in Surgery |
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| Online Zugang: | https://www.frontiersin.org/articles/10.3389/fsurg.2024.1398829/full |
| _version_ | 1826951380381728768 |
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| author | Mestet Yibeltal Shiferaw Abat Sahlu Baleh Abel Gizaw Tsegazeab Laeke Teklemariam Abenezer Tirsit Aklilu Atalel Fentahun Awedew Denekew Tenaw Anley Bereket Hailu Mekuria Ermias Fikiru Yesuf Mengistu Ayele Yigzaw Henok Teshome Molla Mekides Muse Awano Alemu Adise Mldie Endeshaw Chekole Abebe Nebyou Hailu Sura Daniel Dejen Teke Gebrewahd |
| author_facet | Mestet Yibeltal Shiferaw Abat Sahlu Baleh Abel Gizaw Tsegazeab Laeke Teklemariam Abenezer Tirsit Aklilu Atalel Fentahun Awedew Denekew Tenaw Anley Bereket Hailu Mekuria Ermias Fikiru Yesuf Mengistu Ayele Yigzaw Henok Teshome Molla Mekides Muse Awano Alemu Adise Mldie Endeshaw Chekole Abebe Nebyou Hailu Sura Daniel Dejen Teke Gebrewahd |
| author_sort | Mestet Yibeltal Shiferaw |
| collection | DOAJ |
| description | ObjectiveGlobally, skull base tumors are among the most challenging tumors to treat and are known for their significant morbidity and mortality. Hence, this study aimed to identify robust associated factors that contribute to mortality of patients following surgical resection for a variety of skull base tumors at the 3-month follow-up period. This in turn helps devise an evidence-based meticulous treatment strategy and baseline input for quality improvement work.MethodologyA retrospective cohort study of patients undergoing skull base tumor resection was conducted at two large-volume neurosurgery centers in Ethiopia. The categorical variables were expressed in frequencies and percentages. Normal distribution of continuous data was checked by histogram and the Shapiro–Wilk test. Median with interquartile range (IQR) was calculated for skewed data, while mean with standard deviation (SD) was used for normally distributed data. Odds ratio and adjusted odds ratio (AOR) were used to express the result of univariate and multivariate binary logistic analyses, respectively. A p-value <0.005 was considered statistically significant at 95% confidence interval (CI).ResultThe study involved 266 patients. Of this, women accounted for 63.5% of patients. The median age of patients was 37 (±IQR = 17) years while the median size of the tumor in this study was 4.9 (±IQR 1.5) cm. The mean duration of symptoms at time of presentation was 17.3 (±SD = 11.1) months. Meningioma, pituitary adenoma, and craniopharyngioma contributed to 68.4%, 19.2%, and 9% of the skull-based tumors, respectively. Mortality following skull base tumor resection was 21.1%. On multivariable binary logistic regression analysis, intraoperative iatrogenic vascular insult (AOR = 28.76, 95% CI: 6.12–135.08, p = 0.000), intraventricular hemorrhage (AOR = 6.32, 95% CI: 1.19–33.63, p = 0.031), hospital-associated infection (AOR = 6.96, 95% CI: 2.04–23.67, p = 0.002), and extubation time exceeding 24 h (AOR = 12.89, 95% CI: 4.89–40.34, p = 0.000) were statistically significant with 3-month mortality.ConclusionMortality from skull base tumor resection remains high in our setting. Holistic pre-operative surgical planning, meticulous intraoperative execution of procedures, and post-operative dedicated follow-up of patients in a neurointensive care unit alongside quality improvement works on identified risks of mortality are strongly recommended to improve patient outcomes. The urgent need for setup improvement and further training of neurosurgeons is also underscored. |
| first_indexed | 2025-02-17T22:49:28Z |
| format | Article |
| id | doaj.art-1e75603d38c44b329e3e6adf3669ca4f |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2025-02-17T22:49:28Z |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-1e75603d38c44b329e3e6adf3669ca4f2024-12-03T04:23:01ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2024-12-011110.3389/fsurg.2024.13988291398829Predictors of mortality at 3 months in patients with skull base tumor resections in a low-income settingMestet Yibeltal Shiferaw0Abat Sahlu Baleh1Abel Gizaw2Tsegazeab Laeke Teklemariam3Abenezer Tirsit Aklilu4Atalel Fentahun Awedew5Denekew Tenaw Anley6Bereket Hailu Mekuria7Ermias Fikiru Yesuf8Mengistu Ayele Yigzaw9Henok Teshome Molla10Mekides Muse Awano11Alemu Adise Mldie12Endeshaw Chekole Abebe13Nebyou Hailu14Sura Daniel15Dejen Teke Gebrewahd16Department of Surgery, Neurosurgery Unit, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Surgery, Neurosurgery Unit, Addis Ababa University, Addis Ababa, EthiopiaDepartment of Surgery, Neurosurgery Unit, Addis Ababa University, Addis Ababa, EthiopiaDepartment of Surgery, Neurosurgery Unit, Addis Ababa University, Addis Ababa, EthiopiaDepartment of Surgery, Neurosurgery Unit, Addis Ababa University, Addis Ababa, EthiopiaDepartment of Surgery, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaDepartment of Surgery, Neurosurgery Unit, Addis Ababa University, Addis Ababa, EthiopiaDepartment of Surgery, Neurosurgery Unit, Debre Birhan University, Debre Birhan, EthiopiaDepartment of Surgery, Neurosurgery Unit, Hawassa University, Hawassa, EthiopiaDepartment of Surgery, Neurosurgery Unit, Addis Ababa University, Addis Ababa, EthiopiaDepartment of Surgery, Neurosurgery Unit, Addis Ababa University, Addis Ababa, EthiopiaDepartment of Surgery, Neurosurgery Unit, Jimma University, Jimma, EthiopiaDepartment of Clinical Health Science - Precision Health, University of South Australia, Adelaide, SA, AustraliaDepartment of Surgery, Neurosurgery Unit, Hawassa University, Hawassa, EthiopiaDepartment of Surgery, Neurosurgery Unit, Addis Ababa University, Addis Ababa, EthiopiaDepartment of Surgery, Neurosurgery Unit, Addis Ababa University, Addis Ababa, EthiopiaObjectiveGlobally, skull base tumors are among the most challenging tumors to treat and are known for their significant morbidity and mortality. Hence, this study aimed to identify robust associated factors that contribute to mortality of patients following surgical resection for a variety of skull base tumors at the 3-month follow-up period. This in turn helps devise an evidence-based meticulous treatment strategy and baseline input for quality improvement work.MethodologyA retrospective cohort study of patients undergoing skull base tumor resection was conducted at two large-volume neurosurgery centers in Ethiopia. The categorical variables were expressed in frequencies and percentages. Normal distribution of continuous data was checked by histogram and the Shapiro–Wilk test. Median with interquartile range (IQR) was calculated for skewed data, while mean with standard deviation (SD) was used for normally distributed data. Odds ratio and adjusted odds ratio (AOR) were used to express the result of univariate and multivariate binary logistic analyses, respectively. A p-value <0.005 was considered statistically significant at 95% confidence interval (CI).ResultThe study involved 266 patients. Of this, women accounted for 63.5% of patients. The median age of patients was 37 (±IQR = 17) years while the median size of the tumor in this study was 4.9 (±IQR 1.5) cm. The mean duration of symptoms at time of presentation was 17.3 (±SD = 11.1) months. Meningioma, pituitary adenoma, and craniopharyngioma contributed to 68.4%, 19.2%, and 9% of the skull-based tumors, respectively. Mortality following skull base tumor resection was 21.1%. On multivariable binary logistic regression analysis, intraoperative iatrogenic vascular insult (AOR = 28.76, 95% CI: 6.12–135.08, p = 0.000), intraventricular hemorrhage (AOR = 6.32, 95% CI: 1.19–33.63, p = 0.031), hospital-associated infection (AOR = 6.96, 95% CI: 2.04–23.67, p = 0.002), and extubation time exceeding 24 h (AOR = 12.89, 95% CI: 4.89–40.34, p = 0.000) were statistically significant with 3-month mortality.ConclusionMortality from skull base tumor resection remains high in our setting. Holistic pre-operative surgical planning, meticulous intraoperative execution of procedures, and post-operative dedicated follow-up of patients in a neurointensive care unit alongside quality improvement works on identified risks of mortality are strongly recommended to improve patient outcomes. The urgent need for setup improvement and further training of neurosurgeons is also underscored.https://www.frontiersin.org/articles/10.3389/fsurg.2024.1398829/fullEthiopiameningiomamortalitypituitary adenomaresectionskull base tumors |
| spellingShingle | Mestet Yibeltal Shiferaw Abat Sahlu Baleh Abel Gizaw Tsegazeab Laeke Teklemariam Abenezer Tirsit Aklilu Atalel Fentahun Awedew Denekew Tenaw Anley Bereket Hailu Mekuria Ermias Fikiru Yesuf Mengistu Ayele Yigzaw Henok Teshome Molla Mekides Muse Awano Alemu Adise Mldie Endeshaw Chekole Abebe Nebyou Hailu Sura Daniel Dejen Teke Gebrewahd Predictors of mortality at 3 months in patients with skull base tumor resections in a low-income setting Frontiers in Surgery Ethiopia meningioma mortality pituitary adenoma resection skull base tumors |
| title | Predictors of mortality at 3 months in patients with skull base tumor resections in a low-income setting |
| title_full | Predictors of mortality at 3 months in patients with skull base tumor resections in a low-income setting |
| title_fullStr | Predictors of mortality at 3 months in patients with skull base tumor resections in a low-income setting |
| title_full_unstemmed | Predictors of mortality at 3 months in patients with skull base tumor resections in a low-income setting |
| title_short | Predictors of mortality at 3 months in patients with skull base tumor resections in a low-income setting |
| title_sort | predictors of mortality at 3 months in patients with skull base tumor resections in a low income setting |
| topic | Ethiopia meningioma mortality pituitary adenoma resection skull base tumors |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2024.1398829/full |
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