| アブストラクト | BACKGROUND: Asymptomatic or minor symptom meningiomas (AMSMs) in the elderly are incidental findings, with no consensus reached on the optimal management strategy. In the present study, we aimed to determine the surgical risk factors for elderly patients with AMSMs using a nationwide registry database in Japan. METHODS: We identified patients with surgically treated AMSMs using the Diagnosis Procedure Combination database from 2010 to 2015 and reviewed the medical records for age (<65 years; pre-elderly, 65-74 years; and elderly, >/=75 years), sex, Barthel index (BI) score, medical history, tumor location, and complications. An AMSM was defined by a BI score of 100 points at admission. The risk factors for all stroke complications, BI deterioration at discharge, and in-hospital mortality were determined using multivariate logistic regression analyses. RESULTS: From a total of 10,535 patients with meningioma, 6628 were included. Advanced age was a significant risk factor (odds ratio, 3.54; 95% confidence interval, 2.80-4.46) for BI deterioration but not for all-stroke complications or in-hospital mortality. Midline and posterior fossa tumors, diabetes mellitus, and chronic heart disease were significant risk factors for in-hospital mortality. CONCLUSIONS: For elderly patients with surgically treated AMSMs, advanced age was a prominent risk factor for functional decline at discharge. Our study identified several factors that should be evaluated before proceeding with surgery for AMSMs in elderly and pre-elderly patients. These findings could, not only improve decision-making among clinicians treating patients with AMSMs, but also help in predicting the results of surgery for elderly patients with AMSMs. |
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| ジャーナル名 | World neurosurgery |
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| 投稿日 | 2021/1/15 |
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| 投稿者 | Ikawa, Fusao; Isobe, Naoyuki; Michihata, Nobuaki; Oya, Soichi; Ohata, Kenji; Saito, Kiyoshi; Yoshida, Kazunari; Fushimi, Kiyohide; Yasunaga, Hideo; Tominaga, Teiji; Kurisu, Kaoru |
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| 組織名 | Department of Neurosurgery, Graduate School of Biomedical and Health Sciences,;Hiroshima University, Hiroshima, Japan; Department of Neurosurgery, Shimane;Prefectural Central Hospital, Izumo, Japan. Electronic address:;fikawa-nsu@umin.ac.jp.;Department of Neurosurgery, JA Onomichi General Hospital, Onomichi, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Department of Neurosurgery, Saitama Medical Center, Saitama, Japan.;Department of Neurosurgery, Osaka City University Graduate School of Medicine,;Osaka, Japan.;Department of Neurosurgery, Fukushima Medical University, Fukushima, Japan.;Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School, Tokyo, Japan.;Department of Neurosurgery, Tohoku University Graduate School of Medicine,;Sendai, Japan.;Hiroshima University, Hiroshima, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33444840/ |
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