Introduction: Postoperative pneumonia is an important cause of surgical morbidity and extended hospitalization in patients undergoing meningioma resections. We studied our institutional experience of patients undergoing craniotomy for meningioma to identify risk factors for postoperative pneumonia and facilitate prevention.
Methods: We retrospectively reviewed all patients undergoing a craniotomy for meningioma at our institution from 2009-2012. Patient age, gender, procedure duration, estimated blood loss (EBL), tumor grade, and incidence of postoperative pneumonia were assessed.
Results: During the study period, 466 patients underwent surgery for meningioma. Patients were predominantly female (330 women versus 136 men), with an average age of 58.0 ± 13.5 years (range 18-92). Histopathology identified 353 grade I, 76 grade II, and 31 grade III tumors. The overall rate of postoperative pneumonia was 1.5%. In this cohort, patients who developed pneumonia were older, with a mean age of 68 ± 13 versus 58 ± 13 years (p=0.05). Increased procedure duration was associated with pneumonia, averaging 598 ± 192 minutes among patients who developed pneumonia compared to 343 ± 180 minutes in those without (p<0.001). Patients who developed pneumonia also had increased EBL, with a mean of 1,000 ± 947 mL compared to 344 ± 429 mL (p<0.001). As expected, the development of pneumonia resulted in significantly longer hospitalizations of 19 ± 6 days compared to 7 ± 6 days (p<0.001). Gender (p=0.97), BMI (p=0.93), and tumor grade (p=0.75) were not associated with postoperative pneumonia. In a multivariate regression model, age (p=0.010), EBL (p=0.046), and procedure duration (p=0.005) were significantly predictive of postoperative pneumonia.
Conclusions: Procedure duration, blood loss, and age are significantly associated with the development of postoperative pneumonia following resection of meningiomas, resulting in prolonged hospitalization. Care should be taken to minimize operative time, particularly in the elderly, to decrease pneumonia rates and shorten hospitalization.
Patient Care: By identifying which risk factors contribute to the development of post-operative pneumonias among patients with meningiomas, our research will help in the construction of better preventative strategies to reduce and minimize this risk.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of prolonged operation times and higher blood volume loss as risk factors for developing post-operative pneumonia among meningioma patients 2) Discuss, in small groups, preventative strategies for reducing post-operative pneumonia rates 3) Identify an effective method for minimizing the risk of developing pneumonias post-operatively among meningioma patients