TY - JOUR
T1 - Four Independent Predictors of Postoperative Seizures After Meningioma Surgery
T2 - A Meta-Analysis
AU - Lu, Victor M.
AU - Wahood, Waseem
AU - Akinduro, Oluwaseun O.
AU - Parney, Ian F.
AU - Quinones-Hinojosa, Alfredo
AU - Chaichana, Kaisorn L.
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/10
Y1 - 2019/10
N2 - Background: Postoperative seizures after surgical resection of intracranial meningiomas will negatively affect the quality of life of patients. The aim of the present meta-analysis was to pool the current data and identify the independent predictors of postoperative seizures to better guide postoperative surveillance. Methods: Searches of 4 electronic databases from inception to February 2019 were conducted using the preferred reporting items for systematic reviews and meta-analyses guidelines. We identified 430 reports for screening. The hazard ratios (HRs) of the preoperative and postoperative parameters from ≥3 separate multivariate regression analyses were pooled using a meta-analysis of the proportions. Results: Of the 430 reports, 12 satisfied the criteria for inclusion in the present study. The pooled population of 5681 patients with meningioma had a median age of 56 years (range, 50–61) and a median proportion of World Health Organization grade I of 91% (range, 66–100). From these data, 4 statistically significant, independent predictors of postoperative seizures were identified: 1) preoperative seizure history (HR, 3.53; P < 0.01), 2) non–skull base location (HR, 2.35; P < 0.01), 3) postoperative complications (HR, 3.95; P < 0.01), and 4) meningioma recurrence (HR, 3.69; P < 0.01). However, the certainty of these results ranged from low to moderate. Conclusions: We identified 4 significant independent predictors of postoperative seizures after meningioma resection. These parameters should be considered in the follow-up of these patients to ensure optimal seizure surveillance, although ultimate validation by prospective studies is still required.
AB - Background: Postoperative seizures after surgical resection of intracranial meningiomas will negatively affect the quality of life of patients. The aim of the present meta-analysis was to pool the current data and identify the independent predictors of postoperative seizures to better guide postoperative surveillance. Methods: Searches of 4 electronic databases from inception to February 2019 were conducted using the preferred reporting items for systematic reviews and meta-analyses guidelines. We identified 430 reports for screening. The hazard ratios (HRs) of the preoperative and postoperative parameters from ≥3 separate multivariate regression analyses were pooled using a meta-analysis of the proportions. Results: Of the 430 reports, 12 satisfied the criteria for inclusion in the present study. The pooled population of 5681 patients with meningioma had a median age of 56 years (range, 50–61) and a median proportion of World Health Organization grade I of 91% (range, 66–100). From these data, 4 statistically significant, independent predictors of postoperative seizures were identified: 1) preoperative seizure history (HR, 3.53; P < 0.01), 2) non–skull base location (HR, 2.35; P < 0.01), 3) postoperative complications (HR, 3.95; P < 0.01), and 4) meningioma recurrence (HR, 3.69; P < 0.01). However, the certainty of these results ranged from low to moderate. Conclusions: We identified 4 significant independent predictors of postoperative seizures after meningioma resection. These parameters should be considered in the follow-up of these patients to ensure optimal seizure surveillance, although ultimate validation by prospective studies is still required.
KW - Meningioma
KW - Non–skull base
KW - Postoperative
KW - Predictors
KW - Seizure
KW - Surgery
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U2 - 10.1016/j.wneu.2019.06.063
DO - 10.1016/j.wneu.2019.06.063
M3 - Review article
C2 - 31226449
AN - SCOPUS:85068806647
SN - 1878-8750
VL - 130
SP - 537-545.e3
JO - World neurosurgery
JF - World neurosurgery
ER -