The epidemiology and outcome of patients admitted for elective brain tumour surgery at a single neurosurgical centre in South Africa
Introduction: Many countries, including South Africa, do not have a national brain tumour registry. Despite this limitation several institutional studies report age, gender, and histological tumour types that are in-line with the findings of the large established national brain tumour registries fro...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-09-01
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| Series: | Interdisciplinary Neurosurgery |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751920302139 |
| _version_ | 1819073737277833216 |
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| author | Adrian Kelly Patrick Lekgwara Siyazi Mda |
| author_facet | Adrian Kelly Patrick Lekgwara Siyazi Mda |
| author_sort | Adrian Kelly |
| collection | DOAJ |
| description | Introduction: Many countries, including South Africa, do not have a national brain tumour registry. Despite this limitation several institutional studies report age, gender, and histological tumour types that are in-line with the findings of the large established national brain tumour registries from the United States and Europe. Materials and methods: We conducted a prospective study consecutively enrolling all elective subjects admitted to our Unit with a neoplastic brain tumor from the 01 July 2018–31 March 2020. The data collected included age, gender, admission Glasgow Coma Score, HIV status, admission absolute CD4 count in all patients, radiological tumour diagnosis, pre-operative steroid treatment, length of in-hospital stay prior to surgery, time between prophylactic antibiotic administration and skin incision, intra-operative blood loss, length of surgery, extent of resection, histological diagnosis, post-operative nosocomial infection incidence, and Glasgow Outcome Score. Results: The mean age of our subjects was 48 (±14.56) years. Significance was demonstrated between age and histological tumour diagnosis (p = 0.031). With regards gender 72/101 (72%) were males and 29/101 (29%) were females. Considering admission HIV status 65/101 (64%) were HIV negative and 36/101 (36%) were HIV positive. Of the 101 subjects enrolled in the study 78/101 (77%) were taken for operative intervention. The mean intra-operative blood loss in our study was 505 (±336) millilitres. The mean length of surgery was 278 (±80.33) minutes. Considering nosocomial infection 30/78 (38%) subjects developed this complication. Considering outcome 29/78 (37%) subjects in our study had a favourable outcome (GOS 4/5), and 49/78 (63%) had an unfavourable outcome (GOS 1–3). Conclusion: Patients with brain tumours, whether HIV positive or not, show characteristic histological tumour types that are age specific. While being HIV positive does have a detrimental influence, the primary histology of the lesion and the extent of resection are the major determinants of outcome. |
| first_indexed | 2024-12-21T17:58:22Z |
| format | Article |
| id | doaj.art-88654d4524354637ad4d9045fe168440 |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-12-21T17:58:22Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-88654d4524354637ad4d9045fe1684402022-12-21T18:55:08ZengElsevierInterdisciplinary Neurosurgery2214-75192020-09-0121100750The epidemiology and outcome of patients admitted for elective brain tumour surgery at a single neurosurgical centre in South AfricaAdrian Kelly0Patrick Lekgwara1Siyazi Mda2Corresponding author at: P.O Box Medunsa, Pretoria, South Africa.; Department of Neurosurgery, Dr George Mukhari Academic Hospital, Sefako Makgatho Health Sciences University, Pretoria, South AfricaDepartment of Neurosurgery, Dr George Mukhari Academic Hospital, Sefako Makgatho Health Sciences University, Pretoria, South AfricaDepartment of Neurosurgery, Dr George Mukhari Academic Hospital, Sefako Makgatho Health Sciences University, Pretoria, South AfricaIntroduction: Many countries, including South Africa, do not have a national brain tumour registry. Despite this limitation several institutional studies report age, gender, and histological tumour types that are in-line with the findings of the large established national brain tumour registries from the United States and Europe. Materials and methods: We conducted a prospective study consecutively enrolling all elective subjects admitted to our Unit with a neoplastic brain tumor from the 01 July 2018–31 March 2020. The data collected included age, gender, admission Glasgow Coma Score, HIV status, admission absolute CD4 count in all patients, radiological tumour diagnosis, pre-operative steroid treatment, length of in-hospital stay prior to surgery, time between prophylactic antibiotic administration and skin incision, intra-operative blood loss, length of surgery, extent of resection, histological diagnosis, post-operative nosocomial infection incidence, and Glasgow Outcome Score. Results: The mean age of our subjects was 48 (±14.56) years. Significance was demonstrated between age and histological tumour diagnosis (p = 0.031). With regards gender 72/101 (72%) were males and 29/101 (29%) were females. Considering admission HIV status 65/101 (64%) were HIV negative and 36/101 (36%) were HIV positive. Of the 101 subjects enrolled in the study 78/101 (77%) were taken for operative intervention. The mean intra-operative blood loss in our study was 505 (±336) millilitres. The mean length of surgery was 278 (±80.33) minutes. Considering nosocomial infection 30/78 (38%) subjects developed this complication. Considering outcome 29/78 (37%) subjects in our study had a favourable outcome (GOS 4/5), and 49/78 (63%) had an unfavourable outcome (GOS 1–3). Conclusion: Patients with brain tumours, whether HIV positive or not, show characteristic histological tumour types that are age specific. While being HIV positive does have a detrimental influence, the primary histology of the lesion and the extent of resection are the major determinants of outcome.http://www.sciencedirect.com/science/article/pii/S2214751920302139 |
| spellingShingle | Adrian Kelly Patrick Lekgwara Siyazi Mda The epidemiology and outcome of patients admitted for elective brain tumour surgery at a single neurosurgical centre in South Africa Interdisciplinary Neurosurgery |
| title | The epidemiology and outcome of patients admitted for elective brain tumour surgery at a single neurosurgical centre in South Africa |
| title_full | The epidemiology and outcome of patients admitted for elective brain tumour surgery at a single neurosurgical centre in South Africa |
| title_fullStr | The epidemiology and outcome of patients admitted for elective brain tumour surgery at a single neurosurgical centre in South Africa |
| title_full_unstemmed | The epidemiology and outcome of patients admitted for elective brain tumour surgery at a single neurosurgical centre in South Africa |
| title_short | The epidemiology and outcome of patients admitted for elective brain tumour surgery at a single neurosurgical centre in South Africa |
| title_sort | epidemiology and outcome of patients admitted for elective brain tumour surgery at a single neurosurgical centre in south africa |
| url | http://www.sciencedirect.com/science/article/pii/S2214751920302139 |
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