Association between hypertension requiring medication and postoperative 30-day mortality in adult patients with tumor craniotomy: an analysis of data using propensity score matching

Yufei Liu; Haofei Hu; Wenjian Zheng; Zhong Deng; Jihu Yang; Xiejun Zhang; Zongyang Li; Lei Chen; Fanfan Chen; Nan Ji; Guodong Huang

doi:10.3389/fneur.2024.1412471

Association between hypertension requiring medication and postoperative 30-day mortality in adult patients with tumor craniotomy: an analysis of data using propensity score matching

Front Neurol. 2024 Sep 17:15:1412471. doi: 10.3389/fneur.2024.1412471. eCollection 2024.

Authors

Yufei Liu^#¹, Haofei Hu^#², Wenjian Zheng¹, Zhong Deng¹, Jihu Yang¹, Xiejun Zhang¹, Zongyang Li¹, Lei Chen¹, Fanfan Chen¹, Nan Ji³, Guodong Huang^#¹

Affiliations

¹ Department of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China.
² Nephrological Department, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China.
³ Neurosurgical Department, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

^# Contributed equally.

Abstract

Background: Reliable quantification of the association between hypertension requiring medication and postoperative 30-day mortality in adult patients who undergo craniotomy for tumor resection is limited. We aimed to explore the associations between these factors.

Materials and methods: This work was a retrospective cohort study that used propensity score matching (PSM) among 18,642 participants from the American College of Surgeons National Surgical Quality Improvement Program database between 2012 and 2015. Hypertension requiring medication and postoperative 30-day mortality were the independent and dependent target variables, respectively. PSM was conducted via nonparsimonious multivariate logistic regression to balance the confounders. Robust estimation methods were used to investigate the association between hypertension requiring medication and postoperative 30-day mortality.

Results: A total of 18,642 participants (52.6% male and 47.4% female) met our inclusion criteria; 7,116 (38.17%) participants with hypertension required medication and had a 3.74% mortality rate versus an overall mortality rate of 2.46% in the adult cohort of patients who underwent craniotomy for tumor resection. In the PSM cohort, the risk of postoperative 30-day mortality significantly increased by 39.0% among patients with hypertension who required medication (OR = 1.390, 95% confidence interval (CI): 1.071-1.804, p = 0.01324) after adjusting for the full covariates. Compared with participants without hypertension requiring medication, those with hypertension requiring medication had a 34.0% greater risk of postoperative 30-day mortality after adjusting for the propensity score (OR = 1.340, 95% CI: 1.040-1.727, p = 0.02366) and a 37.6% greater risk of postoperative 30-day mortality in the inverse probability of treatment weights (IPTW) cohort (OR = 1.376, 95% CI: 1.202, 1.576, p < 0.00001).

Conclusion: Among U.S. adult patients undergoing craniotomy for tumor resection, hypertension requiring medication is a notable contributor to 30-day mortality after surgery, with odds ratios ranging from 1.34 to 1.39.

Keywords: brain tumor; craniotomy; hypertension; mortality; propensity score matching.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Shenzhen Second People’s Hospital Clinical Research Fund of the Guangdong Province High-level Hospital Construction Project (Grant no. 20233357023).