MNGO-13: INCREASED RISK OF PERMANENT NEUROLOGIC DEFICITS FOLLOWING MENINGIOMA RESECTION IN THE ELDERLY

INTRODUCTION: Recent studies have inconsistently identified increased age as a predictor of higher perioperative morbidity and mortality in patients surgically treated for a meningioma. We sought to quantify the occurrence of permanent neurologic deficits after operative treatment of meningiomas and to analyze the association of such deficits with patient age. METHODS: We conducted a retrospective cohort study on 223 patients who underwent primary meningioma resection at our institution between 2001-2013. All postoperative entries in the medical record were reviewed for each patient and all new neurological deficits were recorded. Postoperative deficits were defined as permanent if clinically evident at one-year postoperatively. Temporary neurological deficits, non-neurological complications, and pre-existing neurological deficits were not included in our analysis. Patients were stratified into two groups, young and elderly, based on age at time of operation of less than 60 years and 60 years and above respectively. Pearson's correlation and Fisher's exact test were utilized to examine the association of age with the rate of postoperative neurologic deficits. RESULTS: Average age at time of operation was 55.0 ± 14.5 years. 137 and 86 patients were included in the young and elderly subgroups respectively. Overall, 27 (12%) patients suffered from permanent neurological deficits postoperatively. There was a significant positive correlation between increased patient age and risk of permanent neurologic deficits (r = 0.17, p = 0.012). The risk of a new neurologic deficit was 7.3% in the young subgroup of patients versus 20.0% in the elderly subgroup. The increased risk of permanent neurologic deficits postoperatively was significantly higher in the elderly group (relative risk = 2.7, p = 0.010). CONCLUSIONS: Increased age is associated with a higher risk of permanent postoperative neurologic deficits after meningioma resection. Elderly patients are at increased risk of postoperative deterioration and this should be carefully considered before proposing resection of a meningioma in this patient subgroup.