PDF(Pubmed)
Abstract：
UNASSIGNED: Perioperative variable parameters can be significant risk factors for postoperative intensive care unit (ICU) admission after elective craniotomy for intracranial neoplasm, as assessed by various scoring systems such as Cranio Score. This observational study evaluates the relationship between these factors and early postoperative neurological complications necessitating ICU admission.
UNASSIGNED: In total, 119 patients, aged 18 years and above, of either sex, American Society of Anesthesiologists (ASA) grades I-III, scheduled for elective craniotomy and tumor excision were included. The primary objective was to evaluate the relationship between perioperative risk factors and the incidence of early postoperative complications as a means of validation of the Cranio Score. The secondary outcomes studied were 30-day postoperative morbidity/mortality and the association with patient-related risk factors.
UNASSIGNED: Forty-five of 119 patients (37.82%) required postoperative ICU care with the mean duration of ICU stay being 1.92 ± 4.91 days. Tumor location (frontal/infratemporal region), preoperative deglutition disorder, Glasgow Coma Scale (GCS) less than 15, motor deficit, cerebellar deficit, midline shift >3 mm, mass effect, tumor size, use of blood products, lateral position, inotropic support, elevated systolic/mean arterial pressures, and duration of anesthesia/surgery were associated with a higher incidence of ICU care. Maximum (P = 0.035, AOR = 1.130) and minimum systolic arterial pressures (P = 0.022, Adjusted Odds Ratio (AOR) = 0.861) were the only independent risk factors. Cranio Score was found to be an accurate predictor of complications at a cut-off point of >10.52%. The preoperative motor deficit was the only independent risk factor associated with 30-day morbidity (AOR = 4.66).
UNASSIGNED: Perioperative hemodynamic effects are an independent predictor of postoperative ICU requirement. Further Cranio Score is shown to be a good scoring system for postoperative complications.
UNASSIGNED: In total, 119 patients, aged 18 years and above, of either sex, American Society of Anesthesiologists (ASA) grades I-III, scheduled for elective craniotomy and tumor excision were included. The primary objective was to evaluate the relationship between perioperative risk factors and the incidence of early postoperative complications as a means of validation of the Cranio Score. The secondary outcomes studied were 30-day postoperative morbidity/mortality and the association with patient-related risk factors.
UNASSIGNED: Forty-five of 119 patients (37.82%) required postoperative ICU care with the mean duration of ICU stay being 1.92 ± 4.91 days. Tumor location (frontal/infratemporal region), preoperative deglutition disorder, Glasgow Coma Scale (GCS) less than 15, motor deficit, cerebellar deficit, midline shift >3 mm, mass effect, tumor size, use of blood products, lateral position, inotropic support, elevated systolic/mean arterial pressures, and duration of anesthesia/surgery were associated with a higher incidence of ICU care. Maximum (P = 0.035, AOR = 1.130) and minimum systolic arterial pressures (P = 0.022, Adjusted Odds Ratio (AOR) = 0.861) were the only independent risk factors. Cranio Score was found to be an accurate predictor of complications at a cut-off point of >10.52%. The preoperative motor deficit was the only independent risk factor associated with 30-day morbidity (AOR = 4.66).
UNASSIGNED: Perioperative hemodynamic effects are an independent predictor of postoperative ICU requirement. Further Cranio Score is shown to be a good scoring system for postoperative complications.
摘要：
■围手术期可变参数可能是颅内肿瘤选择性开颅术后重症监护病房（ICU）入院的重要危险因素，由各种评分系统评估，如Cranio评分。这项观察性研究评估了这些因素与需要入住ICU的术后早期神经系统并发症之间的关系。
■总共，119名患者,18岁及以上，无论性别，美国麻醉医师协会（ASA）I-III级，计划进行选择性开颅手术和肿瘤切除。主要目的是评估围手术期危险因素与术后早期并发症发生率之间的关系，以验证Cranio评分。研究的次要结局是术后30天的发病率/死亡率以及与患者相关危险因素的关联。
■119例患者中有45例（37.82％）需要术后ICU护理，平均ICU停留时间为1.92±4.91天。肿瘤位置（额叶/颞下区域），术前吞咽障碍,格拉斯哥昏迷量表（GCS）小于15，运动缺陷，小脑赤字,中线偏移>3毫米，质量效应,肿瘤大小,使用血液制品，横向位置,正性肌力支持，收缩压/平均动脉压升高，麻醉/手术持续时间与ICU护理发生率较高相关.最大（P=0.035，AOR=1.130）和最小收缩压（P=0.022，调整比值比（AOR）=0.861）是唯一的独立危险因素。发现颅骨评分在>10.52%的临界点是并发症的准确预测因子。术前运动功能障碍是影响30d发病的唯一独立危险因素(AOR=4.66)。
■围手术期血流动力学影响是术后ICU需求的独立预测因素。进一步的Cranio评分被证明是术后并发症的良好评分系统。
■总共，119名患者,18岁及以上，无论性别，美国麻醉医师协会（ASA）I-III级，计划进行选择性开颅手术和肿瘤切除。主要目的是评估围手术期危险因素与术后早期并发症发生率之间的关系，以验证Cranio评分。研究的次要结局是术后30天的发病率/死亡率以及与患者相关危险因素的关联。
■119例患者中有45例（37.82％）需要术后ICU护理，平均ICU停留时间为1.92±4.91天。肿瘤位置（额叶/颞下区域），术前吞咽障碍,格拉斯哥昏迷量表（GCS）小于15，运动缺陷，小脑赤字,中线偏移>3毫米，质量效应,肿瘤大小,使用血液制品，横向位置,正性肌力支持，收缩压/平均动脉压升高，麻醉/手术持续时间与ICU护理发生率较高相关.最大（P=0.035，AOR=1.130）和最小收缩压（P=0.022，调整比值比（AOR）=0.861）是唯一的独立危险因素。发现颅骨评分在>10.52%的临界点是并发症的准确预测因子。术前运动功能障碍是影响30d发病的唯一独立危险因素(AOR=4.66)。
■围手术期血流动力学影响是术后ICU需求的独立预测因素。进一步的Cranio评分被证明是术后并发症的良好评分系统。
