Association between preoperative platelet and 30-day postoperative mortality of adult patients undergoing craniotomy for brain tumors: data from the American College of Surgeons National Surgical Quality Improvement Program database

Liu, Yufei; Hu, Haofei; Li, Zongyang; Yang, Jihu; Zhang, Xiejun; Chen, Lei; Chen, Fanfan; Li, Weiping; Ji, Nan; Huang, Guodong

doi:10.1186/s12883-022-03005-5

Cited by 3 publications

(4 citation statements)

References 30 publications

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“…We employed the log-likelihood ratio test to determine the most suitable model for elaborating the link between them. We followed the methods of Liu et al ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

“…We finally tested for interactions by employing the likelihood ratio test for models with and without interaction terms ( 28 , 29 ). We followed the methods of Liu et al ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

“…All results were reported in compliance with the STROBE statement guidelines. We followed the methods of Liu et al ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

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Association between preoperative hematocrit and postoperative 30-day mortality in adult patients with tumor craniotomy

Liu

et al. 2023

Front. Neurol.

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BackgroundThe purpose of this research was to synthesize the American College of Surgeons National Surgical Quality Improvement Program database to investigate the link between preoperative hematocrit and postoperative 30-day mortality in patients with tumor craniotomy.MethodsA secondary retrospective analysis of electronic medical records of 18,642 patients with tumor craniotomy between 2012 and 2015 was performed. The principal exposure was preoperative hematocrit. The outcome measure was postoperative 30-day mortality. We used the binary logistic regression model to explore the link between them and conducted a generalized additive model and smooth curve fitting to investigate the link and its explicit curve shape. We conducted sensitivity analyses by converting a continuous HCT into a categorical variable and calculated an E-value.ResultsA total of 18,202 patients (47.37% male participants) were included in our analysis. The postoperative 30-day mortality was 2.5% (455/18,202). After adjusting for covariates, we found that preoperative hematocrit was positively associated with postoperative 30-day mortality (OR = 0.945, 95% CI: 0.928, 0.963). A non-linear relationship was also discovered between them, with an inflection point at a hematocrit of 41.6. The effect sizes (OR) on the left and right sides of the inflection point were 0.918 (0.897, 0.939) and 1.045 (0.993, 1.099), respectively. The sensitivity analysis proved that our findings were robust. The subgroup analysis demonstrated that a weaker association between preoperative hematocrit and postoperative 30-day mortality was found for patients who did not use steroids for chronic conditions (OR = 0.963, 95% CI: 0.941–0.986), and a stronger association was discovered in participants who used steroids (OR = 0.914, 95% CI: 0.883–0.946). In addition, there were 3,841 (21.1%) cases in the anemic group (anemia is defined as a hematocrit (HCT) <36% in female participants and <39% in male participants). In the fully adjusted model, compared with the non-anemic group, patients in the anemic group had a 57.6% increased risk of postoperative 30-day mortality (OR = 1.576; 95% CI: 1.266, 1.961).ConclusionThis study confirms that a positive and nonlinear association exists between preoperative hematocrit and postoperative 30-day mortality in adult patients undergoing tumor craniotomy. Preoperative hematocrit was significantly associated with postoperative 30-day mortality when the preoperative hematocrit was <41.6.

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“…We employed the log-likelihood ratio test to determine the most suitable model for elaborating the link between them. We followed the methods of Liu et al ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

“…We finally tested for interactions by employing the likelihood ratio test for models with and without interaction terms ( 28 , 29 ). We followed the methods of Liu et al ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

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Association between preoperative hematocrit and postoperative 30-day mortality in adult patients with tumor craniotomy

Liu

et al. 2023

Front. Neurol.

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“…All results were reported in compliance with the STROBE statement guidelines. We followed the methods of Liu et al [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Association between preoperative serum sodium and postoperative 30-day mortality in adult patients with tumor craniotomy

Liu,

Hu,

et al. 2023

BMC Neurol

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Background Limited data exist regarding preoperative serum sodium (Na) and 30-day mortality in adult patients with tumor craniotomy. Therefore, this study investigates their relationship. Methods A secondary retrospective analysis was performed using data from the ACS NSQIP database (2012–2015). The principal exposure was preoperative Na. The outcome measure was 30-day postoperative mortality. Binary logistic regression modeling was conducted to explore the link between them, and a generalized additive model and smooth curve fitting were applied to evaluate the potential association and its explicit curve shape. We also conducted sensitivity analyses and subgroup analyses. Results A total of 17,844 patients (47.59% male) were included in our analysis. The mean preoperative Na was 138.63 ± 3.23 mmol/L. The 30-day mortality was 2.54% (455/17,844). After adjusting for covariates, we found that preoperative Na was negative associated with 30-day mortality. (OR = 0.967, 95% CI:0.941, 0.994). For patients with Na ≤ 140, each increase Na was related to a 7.1% decreased 30-day mortality (OR = 0.929, 95% CI:0.898, 0.961); for cases with Na > 140, each increased Na unit was related to a 8.8% increase 30-day mortality (OR = 1.088, 95% CI:1.019, 1.162). The sensitivity analysis and subgroup analysis indicated that the results were robust. Conclusions This study shows a positive and nonlinear association between preoperative Na and postoperative 30-day mortality in adult patients with tumor craniotomy. Appropriate preoperative Na management and maintenance of serum Na near the inflection point (140) may reduce 30-day mortality.

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Association between preoperative white blood cell counts and thirty-day surgical mortality after craniotomy in adult intracranial tumor patients

Gao,

Huang,

Fang

et al. 2024

Front. Neurol.

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ObjectiveWhite blood cell (WBC) counts has been identified as a prognostic biomarker which frequently predict adverse outcomes and mortality risk in various conditions. However, evidence for the association between WBC counts and short-term outcomes after intracranial tumor resection remains limited. This study aimed to explore associations between preoperative WBC counts and thirty-day surgical mortality after craniotomy in adult intracranial tumor patients.MethodsThis retrospective cohort study performed secondary analysis of 18,049 intracranial tumor craniotomy patients from the ACS NSQIP database (2012–2015). The major exposure and outcome were preoperative WBC counts and thirty-day surgical mortality, respectively. Cox regression modeling assessed the linear association between them. Non-linear associations between them were evaluated by conducting smooth curve fitting using an additive Cox proportional hazard model in conjunction with segmented linear regression modeling. Subgroup analysis and interaction testing assessed effect modification. Sensitivity analysis evaluated result robustness.ResultsThe total thirty-day surgical mortality after craniotomy was 2.49% (450/18,049). The mean of preoperative WBC counts was 9.501 ± 4.402 × 10^9/L. Fully adjusted model shows that elevated preoperative WBC counts was independently associated with increased thirty-day surgical mortality (HR = 1.057, 95%CI: 1.040, 1.076). Further analysis revealed a non-linear association between them: below a WBC threshold of 13.6 × 10^9/L, higher WBC counts elevated thirty-day mortality (HR = 1.117; 95%CI: 1.077, 1.158), while risk plateaued and no significant mortality rise occurred above this level (HR = 1.015, 95%CI: 0.982, 1.050). Steroid usage status has a significant effect modification on the WBC-mortality association (P for interaction = 0.002). The non-linear WBC-mortality association was only present for non-steroid users (HR = 1.158, 95%CI: 1.108, 1.210) but not steroid users (HR = 1.009, 95%CI: 0.966, 1.055). The sensitivity analysis confirmed the result robustness.ConclusionElevated preoperative WBC counts were independently and non-linearly associated with an increased risk of thirty-day surgical mortality in adult non-steroid use patients undergoing craniotomy for intracranial tumors. As a convenient predictor, preoperative WBC data allows improved risk profiling and personalized management in adult intracranial tumor patients.

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Association between preoperative platelet and 30-day postoperative mortality of adult patients undergoing craniotomy for brain tumors: data from the American College of Surgeons National Surgical Quality Improvement Program database

Cited by 3 publications

References 30 publications

Association between preoperative hematocrit and postoperative 30-day mortality in adult patients with tumor craniotomy

Association between preoperative hematocrit and postoperative 30-day mortality in adult patients with tumor craniotomy

Association between preoperative serum sodium and postoperative 30-day mortality in adult patients with tumor craniotomy

Association between preoperative white blood cell counts and thirty-day surgical mortality after craniotomy in adult intracranial tumor patients

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