Perioperative Factors Affecting Neurologic Outcome in Infants Undergoing Surgery for Intracranial Lesion: A Retrospective Study

Background: The short-term neurologic outcome of infants undergoing brain tumor surgery depends on various perioperative factors. This study was undertaken to analyze the effects of perioperative variables on the postoperative neurologic outcome in infants undergoing brain tumor surgery. Methods: We retrospectively reviewed the chart of infants undergoing craniotomy for brain tumor removal from 2000 to 2017. The data related to preoperative variables, intraoperative management details, and postoperative factors were collected and analyzed. The primary outcome measure was occurrence of new postoperative neurologic deficit (POND) and the secondary outcome measure was length of hospital stay (LOHS). Results: Complete data were available for 40 infants undergoing craniotomy for excision of intracranial tumor. New-onset POND was found in 14 infants (35%). Based on logistic regression analysis, POND was associated with use of mannitol and massive blood transfusion (MBT) trended toward significance. Based on linear regression analysis, the risk factor associated with prolonged LOHS was reintubation and POND trended toward significance. Conclusions: In this study, factors associated with new POND were mannitol use and to a certain extent MBT. The variables associated with prolonged LOHS were reintubation and to a certain extent POND. The anesthetic technique, location of tumor, tumor histology, and extent of tumor resection did not influence the occurrence of new POND or prolonged LOHS in infantile intracranial tumor surgery. Further prospective studies with larger samples are required for confirmation of these findings and identification of new perioperative risk factors.