Thirty-day postoperative morbidity and mortality after temporal lobectomy for medically refractory epilepsy

Panagiotis Kerezoudis, Brandon McCutcheon, Meghan E. Murphy, Kenan R. Rajjoub, Daniel Ubl, Elizabeth B. Habermann, Gregory Worrell, Mohamad Bydon, Jamie J. Van Gompel

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

OBJECTIVE Temporal lobectomy is a well-established treatment modality for the management of medically refractory epilepsy in appropriately selected patients. The aim of this study was to assess 30-day morbidity and mortality after temporal lobectomy in cases registered in a national database. METHODS A retrospective cohort analysis was conducted using a multiinstitutional surgical registry compiled between 2006 and 2014. The authors identified patients who underwent anterior temporal lobectomy and/or amygdalohippocampectomy for a primary diagnosis of intractable epilepsy. Univariate and multivariable analyses with regard to patient demographics, comorbidities, operative characteristics, and 30-day outcomes were applied. RESULTS A total of 216 patients were included in the study. The median age was 38 years and 46% of patients were male. The median length of stay was 3 days and the 30-day mortality rate was 1.4%. Fourteen patients (6.5%) developed at least one major complication. Return to the operating room was observed in 7 patients (3.2%). Readmission within 30 days and discharge to a location other than home were available for 2011-2014 (n = 155) and occurred in 11% and 10.3% of patients, respectively. Multivariable regression analysis revealed that increasing age was an independent predictor of discharge disposition other than home and that male sex was a significant risk factor for the development of a major complication. Interestingly, the presence of the attending neurosurgeon and a resident during the procedure was significantly associated with decreased odds of prolonged length of stay (i.e., > 75th percentile [5 days]) and discharge to a location other than home. CONCLUSIONS Using a multiinstitutional surgical registry, 30-day outcome data after temporal lobectomy for medically intractable epilepsy demonstrates a mortality rate of 1.4%, a major complication rate of 6.5%, and a readmission rate of 11%. Temporal lobectomy is an extremely effective therapy for seizures originating there-however, surgical intervention must be weighed against its morbidity and mortality outcomes.

Original languageEnglish (US)
Pages (from-to)1158-1164
Number of pages7
JournalJournal of neurosurgery
Volume128
Issue number4
DOIs
StatePublished - Apr 2018

Keywords

  • Amygdalohippocampectomy
  • Epilepsy surgery
  • NSQIP
  • National Surgical Quality Improvement Program
  • Temporal lobectomy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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