Predicting short-term outcomes following supratentorial tumor surgery

Clin Neurol Neurosurg. 2020 Sep:196:106016. doi: 10.1016/j.clineuro.2020.106016. Epub 2020 Jun 20.

Abstract

Objectives: The LACE+ index risk prediction tool has not been successfully used to predict short-term outcomes after neurosurgery. This study assessed the ability of LACE+ to predict 30-day (30D) adverse outcomes after supratentorial brain tumor surgery.

Patients and methods: LACE+ scores were retrospectively calculated for consecutive patients (n = 624) who received surgery for supratentorial tumors at one multi-center health system (2017-2019). Coarsened exact matching was employed to control for confounding variables. Outcomes including unplanned hospital readmission, emergency department visits, and death were compared for patients with different LACE+ score quartiles (Q1, Q2, Q3, Q4).

Results: 134 patients were matched between Q1 and Q4; 152 patients between Q2 and Q4; 192 patients between Q3 and Q4. LACE+ score was not found to predict readmission within 30D of discharge for Q1 vs Q4 (p = 0.239), Q2 vs Q4 (p = 0.336), or Q3 vs Q4 (p = 0.739). LACE + score also did not predict 30D risk of emergency department visits for Q1 vs Q4 (p = 0.210), Q2 vs Q4 (p = 0.839), or Q3 vs Q4 (p = 0.167). LACE + did predict death within 30D of surgery for Q3 vs Q4 (1.04 % vs 7.29 %, p = 0.039), but not for Q1 vs Q4 (p = 0.625) or Q2 vs Q4 (p = 0.125).

Conclusion: LACE + may not be suitable for characterizing short-term risk of certain perioperative events in a patient population undergoing supratentorial brain tumor surgery.

Keywords: Coarsened exact matching; Discharge predictive tool; Hospital readmission; LACE+ index; Neurosurgery; Outcomes; Supratentorial brain tumor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Neurosurgical Procedures*
  • Patient Discharge
  • Patient Readmission
  • Prognosis
  • Retrospective Studies
  • Supratentorial Neoplasms / surgery*
  • Treatment Outcome