Incidence, risk factors, and clinical implications of postoperative blood in or near the resection cavity after glioma surgery

Introduction: Postoperative hematomas that require reoperation are a serious, but uncommon complication to glioma surgery. However, smaller blood volumes are frequently observed, but their clinical significance is less known. Research question: What are the incidence rates, risk factors, and patient...

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Main Authors: Claes Johnstad, Ingerid Reinertsen, David Bouget, Lisa M. Sagberg, Per S. Strand, Ole Solheim
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Brain and Spine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772529424000742
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author Claes Johnstad
Ingerid Reinertsen
David Bouget
Lisa M. Sagberg
Per S. Strand
Ole Solheim
author_facet Claes Johnstad
Ingerid Reinertsen
David Bouget
Lisa M. Sagberg
Per S. Strand
Ole Solheim
author_sort Claes Johnstad
collection DOAJ
description Introduction: Postoperative hematomas that require reoperation are a serious, but uncommon complication to glioma surgery. However, smaller blood volumes are frequently observed, but their clinical significance is less known. Research question: What are the incidence rates, risk factors, and patient-reported outcomes of all measurable blood in or near the resection cavity on postoperative MRI in diffuse glioma patients? Material and methods: We manually segmented intradural and extradural blood from early postoperative MRI of 292 diffuse glioma resections. Potential associations between blood volume and tumor characteristics, demographics, and perioperative factors were explored using non-parametric methods. The assessed outcomes were generic and disease-specific patient-reported HRQoL. Results: Out of the 292 MRI scans included, 184 (63%) had intradural blood, and 212 (73%) had extradural blood in or near the resection cavity. The median blood volumes were 0.4 mL and 3.0 mL, respectively. Intradural blood volume was associated with tumor volume, intraoperative blood loss, and EOR. Extradural blood volume was associated with age and tumor volume. Greater intradural blood volume was associated with less headache and cognitive improvement, but not after adjustments for tumor volume. Discussion and conclusions: Postoperative blood on early postoperative MRI is common. Intradural blood volumes tend to be larger in patients with larger tumors, more intraoperative blood loss, or undergoing subtotal resections. Extradural blood volumes tend to be larger in younger patients with larger tumors. Postoperative blood in or near the resection cavity that does not require reoperation does not seem to affect HRQoL in diffuse glioma patients.
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spelling doaj-art-4b0cd5f97f4146008ec2501eed28f4db2024-12-15T06:18:24ZengElsevierBrain and Spine2772-52942024-01-014102818Incidence, risk factors, and clinical implications of postoperative blood in or near the resection cavity after glioma surgeryClaes Johnstad0Ingerid Reinertsen1David Bouget2Lisa M. Sagberg3Per S. Strand4Ole Solheim5Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Corresponding author. Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Edvard Griegs gate 8, 7030, Trondheim, Norway.Department of Health Research, SINTEF Digital, Trondheim, Norway; Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, NorwayDepartment of Health Research, SINTEF Digital, Trondheim, NorwayDepartment of Neurosurgery, St. Olav’s Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, NorwayDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neurosurgery, St. Olav’s Hospital, Trondheim University Hospital, Trondheim, NorwayDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neurosurgery, St. Olav’s Hospital, Trondheim University Hospital, Trondheim, NorwayIntroduction: Postoperative hematomas that require reoperation are a serious, but uncommon complication to glioma surgery. However, smaller blood volumes are frequently observed, but their clinical significance is less known. Research question: What are the incidence rates, risk factors, and patient-reported outcomes of all measurable blood in or near the resection cavity on postoperative MRI in diffuse glioma patients? Material and methods: We manually segmented intradural and extradural blood from early postoperative MRI of 292 diffuse glioma resections. Potential associations between blood volume and tumor characteristics, demographics, and perioperative factors were explored using non-parametric methods. The assessed outcomes were generic and disease-specific patient-reported HRQoL. Results: Out of the 292 MRI scans included, 184 (63%) had intradural blood, and 212 (73%) had extradural blood in or near the resection cavity. The median blood volumes were 0.4 mL and 3.0 mL, respectively. Intradural blood volume was associated with tumor volume, intraoperative blood loss, and EOR. Extradural blood volume was associated with age and tumor volume. Greater intradural blood volume was associated with less headache and cognitive improvement, but not after adjustments for tumor volume. Discussion and conclusions: Postoperative blood on early postoperative MRI is common. Intradural blood volumes tend to be larger in patients with larger tumors, more intraoperative blood loss, or undergoing subtotal resections. Extradural blood volumes tend to be larger in younger patients with larger tumors. Postoperative blood in or near the resection cavity that does not require reoperation does not seem to affect HRQoL in diffuse glioma patients.http://www.sciencedirect.com/science/article/pii/S2772529424000742Postoperative hematomasSurgical complicationsGliomasRisk factorsClinical outcomesQuality of life
spellingShingle Claes Johnstad
Ingerid Reinertsen
David Bouget
Lisa M. Sagberg
Per S. Strand
Ole Solheim
Incidence, risk factors, and clinical implications of postoperative blood in or near the resection cavity after glioma surgery
Brain and Spine
Postoperative hematomas
Surgical complications
Gliomas
Risk factors
Clinical outcomes
Quality of life
title Incidence, risk factors, and clinical implications of postoperative blood in or near the resection cavity after glioma surgery
title_full Incidence, risk factors, and clinical implications of postoperative blood in or near the resection cavity after glioma surgery
title_fullStr Incidence, risk factors, and clinical implications of postoperative blood in or near the resection cavity after glioma surgery
title_full_unstemmed Incidence, risk factors, and clinical implications of postoperative blood in or near the resection cavity after glioma surgery
title_short Incidence, risk factors, and clinical implications of postoperative blood in or near the resection cavity after glioma surgery
title_sort incidence risk factors and clinical implications of postoperative blood in or near the resection cavity after glioma surgery
topic Postoperative hematomas
Surgical complications
Gliomas
Risk factors
Clinical outcomes
Quality of life
url http://www.sciencedirect.com/science/article/pii/S2772529424000742
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