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Abstract
Population aging is likely increasing the number of surgically treated very old (≥ 80–year-old) intracranial meningioma (IM) patients. Since there is little data on mortality in this patient group, we studied whether survival of surgically treated very old IM patients differs from survival of a matched general population. We retrospectively identified 83 consecutive very old IM patients (median age 83 years; 69% women) operated between 2010 and 2018. During the first postoperative year, operated IM patients suffered 2.5 times higher mortality as compared to age- and sex-matched general population but no annual survival difference occurred thereafter. Regarding cumulative estimates, no excess mortality was detected after the second postoperative year. Of the patient who were and who were not able to live at home preoperatively, 78% and 42% lived at home within 3 months, respectively. Preoperative loss of capability to live at home associated with a less frequent return to home [odds ratio (95% confidence interval) 0.21 (0.06–0.67)]. Operated very old IM patients had short-term excess mortality but similar cumulative survival as the matched general population. Moreover, most patients returned home soon after surgery.
Highlights
The number of very old (≥ 80-year-old) yet independent intracranial meningioma (IM) patients is constantly increasing as populations a ge[1]
We focused on postoperative excess mortality and on postoperative capability to live at home (CLH)
Nearly half (41%) of the patients presented with significant tumor-related symptoms (Helsinki ASA class 4), which in turn had led to the loss of CLH in 30% of the whole cohort
Summary
The number of very old (≥ 80-year-old) yet independent intracranial meningioma (IM) patients is constantly increasing as populations a ge[1]. Data on the surgical outcome of very old IM patients is limited[9], and no studies to date have addressed excess mortality or home return after surgery in this patient group. We retrospectively studied surgical outcomes of very old IM patients who were operated in a high-volume university hospital. Our primary hypothesis was that very old IM patients suffer from postoperative excess mortality in comparison to the matched general population. The secondary hypothesis was that preoperatively dependent very old IM patients do not recover their independence and return to home after surgery. We hypothesized that major cranial surgery is a high-risk procedure in very old IM patients, and unlikely to be associated with favorable outcome
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