Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP Database
ObjectiveThere is limited evidence to clarify the specific relationship between pre-operative blood urea nitrogen (BUN) and post-operative 30-day mortality in patients undergoing craniotomy for tumors. Therefore, we aimed to investigate this relationship in detail.MethodsElectronic medical records o...
| Main Authors: | , , , , , , , , |
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| Language: | English |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.926320/full |
| _version_ | 1811296161978384384 |
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| author | Yufei Liu Yufei Liu Yufei Liu Haofei Hu Haofei Hu Zongyang Li Zongyang Li Yong Han Yong Han Fanfan Chen Fanfan Chen Mali Zhang Mali Zhang Weiping Li Weiping Li Guodong Huang Guodong Huang Liwei Zhang |
| author_facet | Yufei Liu Yufei Liu Yufei Liu Haofei Hu Haofei Hu Zongyang Li Zongyang Li Yong Han Yong Han Fanfan Chen Fanfan Chen Mali Zhang Mali Zhang Weiping Li Weiping Li Guodong Huang Guodong Huang Liwei Zhang |
| author_sort | Yufei Liu |
| collection | DOAJ |
| description | ObjectiveThere is limited evidence to clarify the specific relationship between pre-operative blood urea nitrogen (BUN) and post-operative 30-day mortality in patients undergoing craniotomy for tumors. Therefore, we aimed to investigate this relationship in detail.MethodsElectronic medical records of 18,642 patients undergoing craniotomy for tumors in the ACS NSQIP from 2012 to 2015 were subjected to secondary retrospective analysis. The principal exposure was pre-operative BUN. Outcome measures were post-operative 30-day mortality. We used binary logistic regression modeling to evaluate the association between them and conducted a generalized additive model and smooth curve fitting (penalized spline method) to explore the potential relationship and its explicit curve shape. We also conducted sensitivity analyses to ensure the robustness of the results and performed subgroup analyses.ResultsA total of 16,876 patients were included in this analysis. Of these, 47.48% of patients were men. The post-operative 30-day mortality of the included cases was 2.49% (420/16,876), and the mean BUN was 16.874 ± 6.648 mg/dl. After adjusting covariates, the results showed that pre-operative BUN was positively associated with post-operative 30-day mortality (OR = 1.020, 95% CI: 1.004, 1.036). There was also a non-linear relationship between BUN and post-operative 30-day mortality, and the inflection point of the BUN was 9.804. For patients with BUN < 9.804 mg/dl, a 1 unit decrease in BUN was related to a 16.8% increase in the risk of post-operative 30-day mortality (OR = 0.832, 95% CI: 0.737, 0.941); for patients with BUN > 9.804 mg/dl, a 1 unit increase in BUN was related to a 2.8% increase in the risk of post-operative 30-day mortality (OR = 1.028, 95% CI: 1.011, 1.045). The sensitivity analysis proved that the results were robust. The subgroup analysis revealed that all listed subgroups did not affect the relationship between pre-operative BUN and post-operative 30-day mortality (P > 0.05).ConclusionOur study demonstrated that pre-operative BUN (mg/dl) has specific linear and non-linear relationships with post-operative 30-day mortality in patients over 18 years of age who underwent craniotomy for tumors. Proper pre-operative management of BUN and maintenance of BUN near the inflection point (9.804 mg/dl) could reduce the risk of post-operative 30-day mortality in these cases. |
| first_indexed | 2024-04-13T05:45:17Z |
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| id | doaj.art-e74727f0229542a899c33ad5dbbf4f3f |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-13T05:45:17Z |
| publishDate | 2022-07-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-e74727f0229542a899c33ad5dbbf4f3f2022-12-22T02:59:59ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-07-011310.3389/fneur.2022.926320926320Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP DatabaseYufei Liu0Yufei Liu1Yufei Liu2Haofei Hu3Haofei Hu4Zongyang Li5Zongyang Li6Yong Han7Yong Han8Fanfan Chen9Fanfan Chen10Mali Zhang11Mali Zhang12Weiping Li13Weiping Li14Guodong Huang15Guodong Huang16Liwei Zhang17Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, ChinaShenzhen University Health Science Center, Shenzhen, ChinaShenzhen University Health Science Center, Shenzhen, ChinaDepartment of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, ChinaShenzhen University Health Science Center, Shenzhen, ChinaShenzhen University Health Science Center, Shenzhen, ChinaDepartment of Emergency, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, ChinaShenzhen University Health Science Center, Shenzhen, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, ChinaShenzhen University Health Science Center, Shenzhen, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, ChinaShenzhen University Health Science Center, Shenzhen, ChinaDepartment of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, ChinaShenzhen University Health Science Center, Shenzhen, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaObjectiveThere is limited evidence to clarify the specific relationship between pre-operative blood urea nitrogen (BUN) and post-operative 30-day mortality in patients undergoing craniotomy for tumors. Therefore, we aimed to investigate this relationship in detail.MethodsElectronic medical records of 18,642 patients undergoing craniotomy for tumors in the ACS NSQIP from 2012 to 2015 were subjected to secondary retrospective analysis. The principal exposure was pre-operative BUN. Outcome measures were post-operative 30-day mortality. We used binary logistic regression modeling to evaluate the association between them and conducted a generalized additive model and smooth curve fitting (penalized spline method) to explore the potential relationship and its explicit curve shape. We also conducted sensitivity analyses to ensure the robustness of the results and performed subgroup analyses.ResultsA total of 16,876 patients were included in this analysis. Of these, 47.48% of patients were men. The post-operative 30-day mortality of the included cases was 2.49% (420/16,876), and the mean BUN was 16.874 ± 6.648 mg/dl. After adjusting covariates, the results showed that pre-operative BUN was positively associated with post-operative 30-day mortality (OR = 1.020, 95% CI: 1.004, 1.036). There was also a non-linear relationship between BUN and post-operative 30-day mortality, and the inflection point of the BUN was 9.804. For patients with BUN < 9.804 mg/dl, a 1 unit decrease in BUN was related to a 16.8% increase in the risk of post-operative 30-day mortality (OR = 0.832, 95% CI: 0.737, 0.941); for patients with BUN > 9.804 mg/dl, a 1 unit increase in BUN was related to a 2.8% increase in the risk of post-operative 30-day mortality (OR = 1.028, 95% CI: 1.011, 1.045). The sensitivity analysis proved that the results were robust. The subgroup analysis revealed that all listed subgroups did not affect the relationship between pre-operative BUN and post-operative 30-day mortality (P > 0.05).ConclusionOur study demonstrated that pre-operative BUN (mg/dl) has specific linear and non-linear relationships with post-operative 30-day mortality in patients over 18 years of age who underwent craniotomy for tumors. Proper pre-operative management of BUN and maintenance of BUN near the inflection point (9.804 mg/dl) could reduce the risk of post-operative 30-day mortality in these cases.https://www.frontiersin.org/articles/10.3389/fneur.2022.926320/fullblood urea nitrogenbrain tumorcraniotomyprognosismortality risk |
| spellingShingle | Yufei Liu Yufei Liu Yufei Liu Haofei Hu Haofei Hu Zongyang Li Zongyang Li Yong Han Yong Han Fanfan Chen Fanfan Chen Mali Zhang Mali Zhang Weiping Li Weiping Li Guodong Huang Guodong Huang Liwei Zhang Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP Database Frontiers in Neurology blood urea nitrogen brain tumor craniotomy prognosis mortality risk |
| title | Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP Database |
| title_full | Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP Database |
| title_fullStr | Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP Database |
| title_full_unstemmed | Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP Database |
| title_short | Association Between Pre-operative BUN and Post-operative 30-Day Mortality in Patients Undergoing Craniotomy for Tumors: Data From the ACS NSQIP Database |
| title_sort | association between pre operative bun and post operative 30 day mortality in patients undergoing craniotomy for tumors data from the acs nsqip database |
| topic | blood urea nitrogen brain tumor craniotomy prognosis mortality risk |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.926320/full |
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