Poon, Michael TC, Piper, Rory J, Thango, Nqobile, Fountain, Daniel M, Marcus, Hani J, Lippa, Laura, Servadei, Franco, Esene, Ignatius N, Freyschlag, Christian F, Neville, Iuri S et al (show 12 more authors)
(2023)
Variation in postoperative outcomes of patients with intracranial tumors: insights from a prospective international cohort study during the COVID-19 pandemic.
Neuro-oncology, 25 (7).
noad019-noad019.
Abstract
<h4>Background</h4>This study assessed the international variation in surgical neuro-oncology practice and 30-day outcomes of patients who had surgery for an intracranial tumor during the COVID-19 pandemic.<h4>Methods</h4>We prospectively included adults aged ≥18 years who underwent surgery for a malignant or benign intracranial tumor across 55 international hospitals from 26 countries. Each participating hospital recorded cases for 3 consecutive months from the start of the pandemic. We categorized patients' location by World Bank income groups (high [HIC], upper-middle [UMIC], and low- and lower-middle [LLMIC]). Main outcomes were a change from routine management, SARS-CoV-2 infection, and 30-day mortality. We used a Bayesian multilevel logistic regression stratified by hospitals and adjusted for key confounders to estimate the association between income groups and mortality.<h4>Results</h4>Among 1016 patients, the number of patients in each income group was 765 (75.3%) in HIC, 142 (14.0%) in UMIC, and 109 (10.7%) in LLMIC. The management of 200 (19.8%) patients changed from usual care, most commonly delayed surgery. Within 30 days after surgery, 14 (1.4%) patients had a COVID-19 diagnosis and 39 (3.8%) patients died. In the multivariable model, LLMIC was associated with increased mortality (odds ratio 2.83, 95% credible interval 1.37-5.74) compared to HIC.<h4>Conclusions</h4>The first wave of the pandemic had a significant impact on surgical decision-making. While the incidence of SARS-CoV-2 infection within 30 days after surgery was low, there was a disparity in mortality between countries and this warrants further examination to identify any modifiable factors.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Writing Group of the COVIDSurg-Cancer neurosurgery investigators on behalf of the COVIDSurg Collaborative; British Neurosurgical Trainee Research Collaborative; WFNS Young Neurosurgeons Committee; NIHR Global Health Research Group on Acquired Brain and Spine Injury |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 21 Apr 2023 09:12 |
| Last Modified: | 21 Jul 2023 05:40 |
| DOI: | 10.1093/neuonc/noad019 |
| Open Access URL: | https://doi.org/10.1093/neuonc/noad019 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3169829 |
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