@article{f9310657d0384815a9f6311940c9d950,
title = "Variation in postoperative outcomes of patients with intracranial tumors: insights from a prospective international cohort study during the COVID-19 pandemic",
abstract = "BackgroundThis study assessed the international variation in surgical neuro-oncology practice and 30-day outcomes of patients who had surgery for an intracranial tumor during the COVID-19 pandemic.MethodsWe prospectively included adults aged ≥18 years who underwent surgery for a malignant or benign intracranial tumor across 55 international hospitals from 26 countries. Each participating hospital recorded cases for 3 consecutive months from the start of the pandemic. We categorized patients{\textquoteright} location by World Bank income groups (high [HIC], upper-middle [UMIC], and low- and lower-middle [LLMIC]). Main outcomes were a change from routine management, SARS-CoV-2 infection, and 30-day mortality. We used a Bayesian multilevel logistic regression stratified by hospitals and adjusted for key confounders to estimate the association between income groups and mortality.ResultsAmong 1016 patients, the number of patients in each income group was 765 (75.3%) in HIC, 142 (14.0%) in UMIC, and 109 (10.7%) in LLMIC. The management of 200 (19.8%) patients changed from usual care, most commonly delayed surgery. Within 30 days after surgery, 14 (1.4%) patients had a COVID-19 diagnosis and 39 (3.8%) patients died. In the multivariable model, LLMIC was associated with increased mortality (odds ratio 2.83, 95% credible interval 1.37–5.74) compared to HIC.ConclusionsThe first wave of the pandemic had a significant impact on surgical decision-making. While the incidence of SARS-CoV-2 infection within 30 days after surgery was low, there was a disparity in mortality between countries and this warrants further examination to identify any modifiable factors.",
author = "{COVIDSurg-Cancer Neurosurgery Investigators} and {British Neurosurgical Trainee Research Collaborative} and {WFNS Young Neurosurgeons Committee} and {NIHR Global Health Research Group on Acquired Brain and Spine Injury} and Poon, {Michael T C} and Piper, {Rory J} and Nqobile Thango and D Fountain and Marcus, {Hani J} and Laura Lippa and Franco Servadei and Esene, {Ignatius N} and Freyschlag, {Christian F} and Neville, {Iuri S} and Gail Rosseau and Karl Schaller and Demetriades, {Andreas K} and Robertson, {Faith C} and Hutchinson, {Peter J} and Price, {Stephen J} and Baticulon, {Ronnie E} and Glasbey, {James C} and Aneel Bhangu and Jenkinson, {Michael D} and Kolias, {Angelos G} and J Burtscher and F Trivik-Barrientos and M Bauer and C Freyschlag and Cunha, {M Lemos Vieira da} and A Persad and H Pham and M Wood and P Christensen and M Haldrup and Iversen, {L H} and Kristensen, {H {\O}} and M Mekhael and N Mikic and A Crespo and P D{\'i}az and N Tactuk and A Abdelsamed and Azzam, {A Y} and H Salem and A Seleim and S Abd-elsalam and H Badr and M Elbahnasawy and M Essa and Badr, {S Gamal} and A Ghoneim and O Hamad and M Hamada and A Hawila and Morsy, {M S} and S Sarsik and Q Ballouhey and H Salle and Duarte, {A Barrios} and Muralles, {I Lopez} and M Lowey and Portilla, {A L} and G Recinos and R Arora and Seenivasagam, {R Kottayasamy} and S Sadhasivam and N Babu and Y Kheni and V Kommu and S Rao and A Moiyadi and D Pandey and Pramesh, {C S} and P Shetty and V Singh and Islam, {A A} and G Kembuan and H Pajan and H Safari and F B{\`a}mbina and G D{\textquoteright}Andrea and P Familiari and V Picotti and P Bruzzaniti and V Chiarella and bartolomeo, {A Di} and A Frati and M Giugliano and P Lapolla and M Salvati and A Santoro and Scafa, {A K} and F Gagliardi and M Medone and P Mortini and M Piloni and A Belvedere and M Droghetti and F Frio and J Neri and Pezzuto, {A P} and G Poggioli and M Rottoli and Russo, {I S} and F Aquila and C Gambacciani and L Lippa and F Pieri and Santonocito, {O S} and Abdallah, {M Al} and F Ayasra and Y Ayasra and A Qasem and Za{\textquoteright}nouneh, {F J Abu} and Al_shraideh, {A A} and T Fahmawee and A Ibrahim and Chaar, {M K Abou} and H Al-Najjar and M Elayyan and M Abusannoga and A Alawami and M Alawami and M Albashri and A Malek and E Abdulwahed and M Biala and R Ghamgh and Y Arkha and H Bechri and Ouahabi, {A El} and Oudrhiri, {M Y} and Azhari, {A El} and Louraoui, {S M} and M Rghioui and M Bougrine and Hassani, {F Derkaoui} and Abbadi, {N El} and A Akinmade and S Fayose and A Okunlola and Y Dawang and J Obande and S Olori and L Abdur-Rahman and N Adeleke and A Adeyeye and S Javed and E Yaqoob and I Al-Slaibi and Alzeerelhouseini, {H I A} and F Jobran and M Alshahrani and F Alsharif and Azab, {M A} and Otaibi, {F Al} and H AlDahash and N Alhazzaa and A Alhefdhi and T AlSumai and F Farrash and P Spangenberg and A Ajlan and A Al-Habib and A Alatar and Nasser, {A Bin} and S Elwatidy and T Nouh and F Abdulfattah and F Alanazi and F Albaqami and K Alsowaina and V Bascarevic and I Bogdanovic and D Gruji{\v c}i{\'c} and R Ilic and M Mili{\'c}evi{\'c} and F Milisavljevi{\'c} and A Miljkovi{\'c} and A Paunovic and V {\v S}{\'c}epanovi{\'c} and A Stanimirovic and M Todorovic and Casta{\~n}o-Leon, {A M} and Fernandez, {J Delgado} and Fernandez, {C Eiriz} and Sinovas, {O Esteban} and Perez, {D Garcia} and P Gomez and L Jimenez-Roldan and A Lagares and L Moreno-Gomez and I Paredes and N{\'u}{\~n}ez, {A P{\'e}rez} and Ansorregui, {I Aldecoa} and Somma, {A Di} and Nora, {J Ense{\~n}at} and N Fabregas and A Ferr{\'e}s and Sanchez, {J J Gonzalez} and I Gracia and Castro, {J A Hoyos} and C Langdon and L Oleaga and L Pedrosa and Carrizo, {J Poblete} and Figueroa, {L A Reyes} and Ramos, {P Roldan} and J Rumia-Arboix and Tercero-Uribe, {A I} and Topczewski, {T E} and J Torales and R Torn{\'e} and R Valero and M Mahfoud and M Bekheit and J Ashcroft and P Coughlin and Davies, {R J} and P Hutchinson and Khan, {D Z} and A Kolias and R Mannion and M Mohan and S Price and T Santarius and A Singh and S Yordanov and M Ganau and D Jeyaretna and R Piper and S Sravanam and N McSorley and A Solth and Y Chowdhury and K Karia and G Solomou and Soon, {W C} and A Stevens and C Topham and I Ughratdar and L Alakandy and P Bhattathiri and J Brown and M Canty and A Grivas and S Hassan and S Lammy and P Littlechild and C Maseland and C Mathieson and R O{\textquoteright}Kane and George, {E St} and N Suttner and W Taylor and Y Al-Tamimi and A Bacon and M Crank and O Rominiyi and S Sinha and Brennan, {P M} and R Pasricha and A Anzak and Silva, {I Leal} and C Sohrabi and B Thakur and P Patkar and I Phang and F Colombo and D Fountain and Hasan, {M T} and K Karabatsou and R Laurente and O Pathmanaban and D Choi and R Hutchison and A Jain and V Luoma and H Marcus and R May and A Menon and B Pramodana and L Webber and T Elmoslemany and M Jenkinson and Millward, {C P} and R Zakaria and B Bigelow and E Etchill and A Gabre-Kidan and H Jenny and M Ladd and C Long and H Malapati and A Margalit and S Rapaport and J Rose and L Tsai and D Vervoort and P Yesantharao and G Arzumanov and N Glass and K Zhao and S Aoun and Ban, {V S} and Batjer, {H H} and J Caruso and Ruzgar, {N M} and M Sion and S Ullrich",
note = "Publisher Copyright: {\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Neuro-Oncology.",
year = "2023",
month = apr,
day = "13",
doi = "10.1093/neuonc/noad019",
language = "English",
journal = "Neuro-Oncology",
issn = "1522-8517",
publisher = "Oxford University Press",
}