Proposal on Incidence and Predictors of Surgery Related Cerebro- Vascular Ischemic Complications among Patients Undergoing Cranial Neuro-OncologicProcedures: Multi- Centric Prospective Observational Study.
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Date
2023-05
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Addis Ababa University
Abstract
Background: Surgical management of brain tumors while proved to be the single most effective
therapeutic armamentarium; it is not however free of some dreadful complications like
cerebrovascular ischemic complications. These ischemic cerebrovascular complications are
separate entities of variable severity of basically the same problem; an ischemic vascular problem
ultimately resulting cerebral infarction and /stroke with significant morbidity and mortality to the
patients. This surgery related cerebrovascular problem comprises of a spectrum of disease entities
that includes cerebral vasospasm, delayed cerebral ischemia (DCI), vascular thrombosis,
pseudoaneurysms, direct iatrogenic vascular injuries and ischemic &/embolic strokes with
different diagnostic modalities, therapeutic options and outcome.
Objective: The main objective of this study will be assessing the incidence and predictors of
surgery related cerebro-vascular ischemic complications among patients undergoing brain tumor
resection at BLH & MCM from April 1-September 30; for 6 months. In addition, this study will
also be developing a risk prediction model for the prediction of cerebral vascular ischemic
complications among the study subjects.
Methodology: A hospital based prospective observational cohort follow-up study will be
conducted starting from April 1-September 30 for the occurrence of ischemic cerebral vascular
complications among patients who underwent cranial surgery for brain tumor resection. The study
outcome will be assessed in patients who underwent brain tumor surgery at the immediate postop,
3-4th post op day, 7-8th post op day, 12-14th post op day and 30th postop day based on a set of
diagnostic criteria and operational definition set. Univariate & bivariable analysis will be done to
see the association of each predictor variable with cerebral vascular ischemic complication.
Variables with p-value of <0.25 in the bivariable analysis will be entered to multivariable analysis.
The statistical significance will be declared at p-value <0.05. The measure of association will be
Risk Ratio (RR) with 95% confidence interval. The risk prediction model will also be presented
in the form of nomogram.
Conclusion: post cranial tumor resection cerebrovascular ischemic complications are grave
complications that have immense implication to the patient’s overall functional outcome. Hence,
this problem warrants study.
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Keywords
Surgical management, Brain tumors