The epidemiology and outcome of patients admitted for elective brain tumour surgery at a single neurosurgical centre in South Africa
Journal – Interdisciplinary Neurosurgery
Publication date – Apr – 2020
Authors – Adrian Kelly,Patrick Lekgwara, Siyazi Mda
Keywords – Epidemiology, Neurosurgery, outcome, South Africa
Open access – Yes
Speciality – Neurosurgery
World region Southern Africa
Country: South Africa
Language – English
Submitted to the One Surgery Index on May 11, 2020 at 12:35 pm
Many countries, including South Africa, do not have a national brain tumour registry. Despite this limitation several institutional studies report age, gender, and histological tumour types that are in-line with the findings of the large established national brain tumour registries from the United States and Europe.
Materials and methods
We conducted a prospective study consecutively enrolling all elective subjects admitted to our Unit with a neoplastic brain tumor from the 01 July 2018–31 March 2020. The data collected included age, gender, admission Glasgow Coma Score, HIV status, admission absolute CD4 count in all patients, radiological tumour diagnosis, pre-operative steroid treatment, length of in-hospital stay prior to surgery, time between prophylactic antibiotic administration and skin incision, intra-operative blood loss, length of surgery, extent of resection, histological diagnosis, post-operative nosocomial infection incidence, and Glasgow Outcome Score.
The mean age of our subjects was 48 (±14.56) years. Significance was demonstrated between age and histological tumour diagnosis (p = 0.031). With regards gender 72/101 (72%) were males and 29/101 (29%) were females. Considering admission HIV status 65/101 (64%) were HIV negative and 36/101 (36%) were HIV positive. Of the 101 subjects enrolled in the study 78/101 (77%) were taken for operative intervention. The mean intra-operative blood loss in our study was 505 (±336) millilitres. The mean length of surgery was 278 (±80.33) minutes. Considering nosocomial infection 30/78 (38%) subjects developed this complication. Considering outcome 29/78 (37%) subjects in our study had a favourable outcome (GOS 4/5), and 49/78 (63%) had an unfavourable outcome (GOS 1–3).
Patients with brain tumours, whether HIV positive or not, show characteristic histological tumour types that are age specific. While being HIV positive does have a detrimental influence, the primary histology of the lesion and the extent of resection are the major determinants of outcome.
OSI Number – 20351