Evidence for the Use of Preoperative Risk Assessment Scores in Elective Cranial Neurosurgery

Abstract

Large prospective studies are needed to validate the use of the reviewed risk scores in elective cranial neurosurgery. It appears, however, that the patient's preoperative physical and functional status can be used to predict the short- and long-term outcome in elective cranial neurosurgery.

Simple Preoperative Patient-Reported Factors Predict Adverse Outcome After Elective Cranial Neurosurgery

“…The Karnofsky Performance Score (KPS), another measure preoperatively assessed in our study cohort. Even though our systematic review found support for the use of KPS in the preoperative risk stratification of patients with intracranial tumors, it remains unclear whether KPS can reliably predict mortality and morbidity in other patient groups 11.…”

“…Limitations of and reasoning behind the used scales have been thoroughly discussed previously. 11 Finally, there is no universal consensus over categorizing complications in neurosurgical patients. Thus, the inclusion of silent strokes and reoperations in major morbidity may be criticized.…”

“…9,10 The role of conventional preoperative risk assessment scores in elective cranial neurosurgery is unclear and the evidence is scarce. 11 Patient-reported outcomes are increasingly used for surgical outcomes reporting. Patientcentered care calls for more direct patient involvement also in the surgical decision-making process.…”

Risk of Postoperative Performance Status Worsening after Resection of Lesions Involving the Motor Pathway: A Multinomial Logistic Regression Model

“…In our cohort, there was a statistically significant difference in postoperative performance status for patients presenting a preoperative ASA score of I/II versus III. This score was found to be associated with functional outcome in intracranial meningiomas, unruptured aneurysms, and gliomas, [25][26][27] as well as a predictor of surgical site infections and postoperative meningitis. 28,29 To the best of our knowledge, this is the first report of an association between ASA scores and postoperative performance status (KPS and mRS) in PMC/CST surgery.…”

The Preoperative Evaluation of the Neurosurgical Patient

“…However, there is no single risk score that can be consistently applied to discriminate between low-risk and high-risk neurosurgical patients. 12 A recent review compared the utility of several neurosurgical and nonspecific risk scores in patients undergoing elective cranial neurosurgery. They assessed the ability of multiple scales to predict both the occurrence of neurosurgical complications, nonspecific surgical complications, and overall morbidity and mortality in patients.…”