Background: Extent of resection (EOR) is well established as correlating with overall survival in patients with glioblastoma (GBM). The impact of EOR on reported quality metrics such as patient safety indicators (PSIs) and hospital-acquired conditions (HACs) is unknown.
Objective: To perform a retrospective study to evaluate possible associations between EOR and the incidence of PSIs and HACs.
Methods: We queried all patients diagnosed with GBM who underwent surgical resection at our institution between January 2011 and May 2017. Pre- and postoperative magnetic resonance images were analyzed for EOR. Each chart was reviewed to determine the incidence of PSIs and HACs.
Results: A total of 284 patients met the inclusion criteria. EOR ranged from 39.00 to 100%, with a median of 99.84% and a mean of 95.7%. There were 16 PSI, and 13 HAC, events. There were no significant differences in the rates of PSIs or HACs when compared between patients stratified by gross total resection (EOR ≥ 95%) and subtotal resection (EOR < 95%). The odds of encountering a PSI or HAC were 2.5 times more likely in the subtotal resection group compared to the gross total resection group (P = .58). After adjusting for confounders, the odds of encountering a PSI or HAC in the subtotal resection group were 3.9 times greater than for the gross total resection group (P < .05).
Conclusion: Gross total resection of GBM is associated with a decreased incidence of PSIs and HACs, as compared to subtotal resection.
Keywords: Extent of resection; Glioblastoma; Glioma; High-grade glioma; Hospital-acquired conditions; Patient safety indicators; Postoperative complications; Quality metrics.
Copyright © 2019 by the Congress of Neurological Surgeons.