Metabolic Syndrome Associated with Increased Rates of Medical Complications Following Intracranial Tumor Resection.

BACKGROUND: When diagnosed simultaneously, obesity, diabetes, and hypertension form a medical constellation called metabolic syndrome (MetS). The prevalence of MetS in Western cultures has been on a steady ascent and MetS has been associated with increased postoperative complications in multiple surgical settings.

OBJECTIVE: In this study, we evaluate the relationship between MetS and the outcomes of craniotomy for supratentorial brain tumor.

METHODS: Cases of craniotomy for supratentorial brain tumors were extracted from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) for the years 2012-2016. The 15,136 identified patients were divided into two cohorts based on the presence (4.1%) or absence (95.9%) of MetS. We compared the two cohorts for preoperative comorbidities, intraoperative details, and postoperative morbidity and mortality.

RESULTS: Patients in the MetS+ cohort were significantly older (63.4 vs. 56.1) year and were more likely to exhibit comorbidities of various organ systems (all p≤0.05). However, operative times were similar (p=0.573). The number of medical complications was almost double in patients with MetS (15.8% vs. 8.5%, p≤0.001). Unplanned readmissions (14.6% vs. 10.4%, p=0.004), reoperations (6.9% vs. 4.6%, p=0.007), and mortality (5.6% vs. 2.9%, p≤0.001) were also more frequent in our MetS+ group. Nevertheless, surgical complications localized to the operative site were not statistically increased (7.4% vs. 5.8%, p = 0.098).

CONCLUSION: A diagnosis of MetS does not appear to be associated with increased rates of surgical site events. However, neurosurgeons should be aware that these patients have significantly higher likelihood of general medical complications, readmissions, reoperations, and death.