Joeky Senders

25 Thirty-day outcomes after craniotomy Introduction Despite improvements in the treatment of primary malignant brain tumors, these invasive cancers continue to result in significant morbidity and mortality. The estimated median survival is as short as 15 months for patients with a glioblastoma, the most common and deadliest type of primary malignant brain tumor. 1 Currently, the standard of care for newly diagnosed primary malignant brain tumors is maximal safe resection of the tumor, typically followed by adjuvant chemotherapy and radiation. 2 Balancing between maximal resection and preservation of neurological functioning canbe challengingdue to the infiltrativenatureof these tumors. Additionally, the short-term postoperative course is frequently complicated by major adverse events, often resulting in extended length of stay, reoperation, and readmission. 3 Identifying the most predominant patient demographics and procedural related factors associated with postoperative morbidity and mortality would be beneficial for improving patient selection and tailoring postoperative management to a patient’s individual risk profile. Although many multicenter studies have reported on short-term outcomes after craniotomy for brain tumors, 4-14 only few have focused on patients with a primary malignant brain tumor. 10-12,15 These studies provide valuable but limited insight into the direct postoperative course because they often assess a specific subset of outcome measures only and use varying inclusion criteria. The current study aims to provide an overall picture of the postoperative course of this patient population by assessing the rates, causes, timing, and predictors of major short-term outcomes after craniotomy for a primary malignant brain tumor. For this purpose, the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NQSIP) database was reviewed to investigate the occurrence of major complications, extended length of stay, reoperation, readmission, and death within the first 30 days following craniotomy. The results of this multicenter study can aid to optimize postoperative management of patients undergoing surgical resection of a primary malignant brain tumor. Methods Data source All patients who underwent a craniotomy for a primary malignant brain tumor were extracted fromtheNSQIP registry (2005-2015). This registry tracks patients prospectively