Safe Brain Tumor Resection Does not Depend on Surgery Alone-Role of Hemodynamics

Stefanie Bette, Benedikt Wiestler, Felicitas Wiedenmann, Johannes Kaesmacher, Martin Bretschneider, Melanie Barz, Thomas Huber, Yu Mi Ryang, Eberhard Kochs, Claus Zimmer, Bernhard Meyer, Tobias Boeckh-Behrens, Jan S. Kirschke, Jens Gempt

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Aim of this study was to determine if perioperative hemodynamics have an impact on perioperative infarct volume and patients' prognosis. 201 cases with surgery for a newly diagnosed or recurrent glioblastoma were retrospectively analyzed. Clinical data and perioperative hemodynamic parameters, blood tests and time of surgery were recorded. Postoperative infarct volume was quantitatively assessed by semiautomatic segmentation. Mean diastolic blood pressure (dBP) during surgery (rho-0.239, 95% CI-0.11-0.367, p = 0.017), liquid balance (rho 0.236, 95% CI 0.1-0.373, p = 0.017) and mean arterial pressure (MAP) during surgery (rho-0.206, 95% CI-0.07-0.34, p = 0.041) showed significant correlation to infarct volume. A rank regression model including also age and recurrent surgery as possible confounders revealed mean intraoperative dBP, liquid balance and length of surgery as independent factors for infarct volume. Univariate survival analysis showed mean intraoperative dBP and MAP as significant prognostic factors, length of surgery also remained as significant prognostic factor in a multivariate model. Perioperative close anesthesiologic monitoring of blood pressure and liquid balance is of high significance during brain tumor surgery and should be performed to prevent or minimize perioperative infarctions and to prolong survival.

Original languageEnglish
Article number5585
JournalScientific Reports
Volume7
Issue number1
DOIs
StatePublished - 1 Dec 2017
Externally publishedYes

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