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首页> 外文期刊>Neurosurgical focus >Risk factors associated with the surgical management of craniopharyngiomas in pediatric patients: analysis of 1961 patients from a national registry database
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Risk factors associated with the surgical management of craniopharyngiomas in pediatric patients: analysis of 1961 patients from a national registry database

机译：儿科患者颅咽神经瘤手术治疗相关的危险因素：国家注册数据库对1961名患者的分析

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OBJECTIVE Patient demographic characteristics, hospital volume, and admission status have been shown to impact surgical outcomes of sellar region tumors in adults; however, the data available following the resection of craniopharyngiomas in the pediatric population remain limited. The authors sought to identify potential risk factors associated with outcomes following surgical management of pediatric craniopharyngiomas. METHODS The Nationwide Inpatient Sample database and Kids' Inpatient Database were analyzed to include admissions for pediatric patients (≤ 18 years) who underwent a transcranial or transsphenoidal craniotomy for resection of a craniopharyngioma. Patient-level factors, including age, race, comorbidities, and insurance type, as well as hospital factors were collected. Outcomes analyzed included mortality rate, endocrine and nonendocrine complications, hospital charges, and length of stay. A multivariate model controlling for variables analyzed was constructed to examine significant independent risk factors. RESULTS Between 2000 and 2011, 1961 pediatric patients were identified who underwent a transcranial (71.2%) or a transsphenoidal (28.8%) craniotomy for resection of a craniopharyngioma. A major predilection for age was observed with the selection of a transcranial (23.4% in CONCLUSIONS This analysis identified patient age, comorbidities, insurance type, hospital bed capacity, and rural or nonteaching hospital status as independent risk factors for postoperative complications and/or increased hospital charges in pediatric patients with craniopharyngioma. Transsphenoidal surgery in younger patients with craniopharyngioma was a risk factor for nonendocrine complications.
机译：目的已显示患者的人口统计学特征，住院量和入院状态会影响成年人鞍区肿瘤的手术效果;然而，小儿人群颅咽管瘤切除术后可获得的数据仍然有限。作者试图确定与小儿颅咽管瘤手术治疗相关的与预后相关的潜在危险因素。方法对全国住院样本数据库和儿童住院数据库进行分析，以纳入经颅或经蝶窦开颅手术切除颅咽管瘤的儿科患者（≤18岁）。收集患者水平的因素，包括年龄，种族，合并症，保险类型以及医院因素。分析的结果包括死亡率，内分泌和非内分泌并发症，住院费用和住院时间。构建了用于控制分析变量的多元模型，以检查重要的独立风险因素。结果在2000年至2011年间，确定了1961例小儿患者，他们接受了经颅（71.2％）或经蝶骨（28.8％）的开颅手术，以切除颅咽管瘤。选择经颅手术是主要的年龄偏倚（结论为23.4％）。该分析确定了患者年龄，合并症，保险类型，医院病床容量以及农村或非教学医院状况是术后并发症和/或增加的独立危险因素。小儿颅咽管瘤患者的住院费用;年轻的颅咽管瘤患者的经蝶窦手术是非内分泌并发症的危险因素。

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