Morbidity and mortality in brain tumour surgery in elderly: a tertiary care hospital based study

Abstract

Background
Brain tumor surgery in elderly patients presents significant challenges due to age-related comorbidities and increased surgical risks. With 50% of primary brain tumors diagnosed after age 65, understanding outcomes in this population is crucial for optimal management strategies.


Objective
To evaluate morbidity and mortality outcomes following brain tumor surgery in patients aged 65 years and older at a tertiary care center.


Methods
This prospective observational study included 56 elderly patients who underwent brain tumor surgery over two years. Comprehensive preoperative assessments, including Karnofsky Performance Scale (KPS) evaluation and American Society of Anesthesiologists (ASA) scoring, were performed. Surgical outcomes, complications, and functional status were monitored through 90-day follow-up. Statistical analysis included univariate and multivariate regression to identify mortality predictors.


Results
The cohort comprised predominantly patients aged 65–69 years (57.1%) with female predominance (53.6%). Hypertension was the most common comorbidity (71.4%). Meningiomas constituted 42.9% of cases, followed by glioblastoma (26.8%). Gross total resection was achieved in 30.4% of patients. Major complications included seizures (16.1%), postoperative hematoma (14.3%), and persistent motor deficits (26.8%). Mortality rates were 33.9% at 30 days and 39.3% at 90 days. Independent predictors of mortality included advanced age (OR 1.12), preoperative KPS < 60 (OR 3.45), infratentorial location (OR 4.26), high-grade malignancy (OR 2.98), and ASA score ≥ 3 (OR 5.12).


Conclusion
Brain tumor surgery in elderly patients carries substantial mortality and morbidity risks. Careful patient selection based on functional status, comorbidity burden, and tumor characteristics is essential for optimizing outcomes.