# Association between disseminated cancer and postoperative 30-day mortality in adult patients with brain tumor craniotomy

## TL;DR

This study finds that patients with disseminated cancer have a higher risk of dying within 30 days after brain tumor surgery.

## Contribution

The study provides empirical evidence of increased postoperative mortality in brain tumor patients with disseminated cancer.

## Key findings

- Patients with disseminated cancer had a 4.97% mortality rate compared to 2.46% in others.
- Odds ratios showed a 1.72 to 2.06 increased risk of mortality for disseminated cancer patients.
- Propensity score matching confirmed the association between disseminated cancer and higher mortality.

## Abstract

Quantitative evidence on the association between disseminated cancer (DC) and 30-day postoperative mortality after tumor resection craniotomy in adults is limited. This study evaluates the association between them.

This retrospective analysis utilized propensity score matching (PSM) on cases extracted from the American College of Surgeons National Surgical Quality Improvement Program database (2012-2015). The study examined DC as the independent variable and 30-day postoperative mortality as the dependent outcome. A logistic regression analysis was conducted on the PSM data that were 1:1 matched. The DC-mortality association was assessed using robust statistical estimation methods.

The study cohort comprised 18,642 eligible patients (52.6% male, 47.4% female), including 4,022 (21.57%) with DC. The mortality rate was significantly higher in DC patients (4.97%) compared to the overall cohort undergoing tumor-related craniotomy (2.46%). Multivariate analysis and propensity score-adjusted analysis demonstrated that, compared with non-DC, the postoperative 30-day mortality of patients with DC undergoing craniotomy for brain tumors significantly increased, with associated odds ratios of 1.72 to 2.06.

Given the relatively high risk of mortality within 30 days after craniotomy in patients with DC, both preoperative surgical decision-making and postoperative management strategies should be appropriately modified to reduce mortality.