KEY TAKEAWAYS
- The study aimed to assess how the RAI predicts postoperative outcomes after intracranial meningioma resection.
- The study concluded that higher RAI-measured frailty predicts increased complication rates, extended length of stay, and mortality.
Frailty poses as an autonomous risk factor for unfavorable postoperative consequences subsequent to intracranial meningioma resection (IMR). While the predictive potential of the Risk Analysis Index (RAI) in postoperative outcomes following IMR is emerging, it holds promise in guiding preoperative patient selection and surgical strategies in brain cancer cases.
Michael M. Covell and the team conducted a study aiming to investigate the impact of frailty, as an independent risk factor, on adverse postoperative outcomes after IMR. Additionally, the study aimed to explore the potential of the RAI in predicting postoperative outcomes following IMR, with implications for preoperative patient selection and surgical planning in individuals with brain cancer.
Patients undergoing IMR were identified from the Nationwide Inpatient Sample using diagnostic and procedural codes from 2019 to 2020. Researchers conducted multivariate analyses to examine the association between preoperative RAI-measured frailty and primary outcomes (non-home discharge and in-hospital mortality), as well as secondary outcomes (extended length of stay and complication rates). The discriminatory accuracy of the RAI for primary outcomes was evaluated using area under the receiver operating characteristic (AUROC) curve analysis.
The results revealed that among 23,230 patients with IMR, frailty statuses were stratified by RAI score: 0–20 categorized as “robust” (R) (10,665 patients, 45.9%), 21–30 as “normal” (N) (8,895 patients, 38.3%), 31–40 as “frail” (F) (2,605 patients, 11.2%), and 41+ as “very frail” (VF) (1,065 patients, 4.6%). Rates of non-home discharge (NHD) (R 11.5%, N 29.7%, F 60.8%, VF 61.5%), in-hospital mortality (R 0.5%, N 1.8%, F 3.8%, VF 7.0%), extended length of stay (eLOS) (R 13.2%, N 21.5%, F 40.9%, VF 46.0%), and complications (R 7.5%, N 11.6%, F 15.7%, VF 16.0%) significantly increased with higher frailty thresholds (p < 0.001). The RAI demonstrated strong discrimination for NHD (C-statistic: 0.755) and in-hospital mortality (C-statistic: 0.754) in AUROC curve analysis.
The study concluded that higher RAI-measured frailty correlates significantly with elevated complication rates, extended length of stay (eLOS), NHD, and in-hospital mortality after IMR. The RAI exhibits robust discriminatory capability in predicting NHD and in-hospital mortality following IMR, offering potential assistance in preoperative risk stratification.
No funding was received.
Source: https://link.springer.com/article/10.1007/s11060-024-04703-5
Covell, M.M., Roy, J.M., Gupta, N., et al. (2024). “Frailty in intracranial meningioma resection: the risk analysis index demonstrates strong discrimination for predicting non-home discharge and in-hospital mortality.” J Neurooncol (2024). https://doi.org/10.1007/s11060-024-04703-5
