The Outcome of Intracranial Meningioma Surgery in Octogenarians: Matched Cohort Study

Background: Previous studies compared outcomes of intracranial meningioma surgery in octogenarians with outcomes in younger patients without accounting for different tumor locations and sizes. The aim of the current study was to evaluate outcomes of intracranial meningioma surgery in octogenarians taking into account patient preoperative status and comorbidities as well as tumor properties. Methods: The study cohort included all octogenarian patients who underwent elective craniotomies for intracranial meningiomas during 2008–2020 and patients <70 years old in the same time period matched for tumor size, tumor location, and preoperative Karnofsky scale score. Each group comprised 31 patients. Postoperative complications were divided into systemic, neurological, and wound related. Mortality and long-term complications were evaluated at 6-month follow-up. Results: Mean age of patients was 82.6 ± 2.6 years for the study group and 57.9 ± 9.9 years for the control group (P < 0.0001). Two octogenarians (6.5%) died within 30 days after elective craniotomy compared with none in the younger group (P = 0.49). Mortality rates at 6 months were comparable between the 2 groups (12.9% vs. 3.2%, P = 0.35). There was no significant difference in overall postoperative complications between the octogenarian and control groups (77.4% vs. 74.2%, P = 0.77). American Society of Anesthesiologists score was the single predictor for any postoperative complications (odds ratio = 2.219, 95% confidence interval 1.024–4.811, P = 0.04). Conclusions: This study found no excess mortality or morbidity in octogenarians compared with younger patients. The American Society of Anesthesiologists score rather than age is a significant risk factor for overall morbidity and mortality following intracranial meningioma surgery in octogenarians.