Complications and death among elderly patients undergoing pituitary tumour surgery

P>Background Preoperative determinants of surgical risk in elderly patients with pituitary tumour are not fully defined. The aim of this study was to quantify operative risk for these patients. Design and methods We performed a retrospective analysis of the Nationwide Inpatient Sample (1998-2005), a database containing discharge information from a stratified, random sample of 20% of all non-federal hospitals in 37 states. Patients > 65 years old who underwent pituitary tumour resection were identified by ICD-9 coding. Primary outcome was inpatient death. Other outcomes included post-operative complications, length of stay (LOS) and total charges. Results A total of 8400 patients (53 center dot 7% male) were identified. Mean age was 72 center dot 2. Mean co-morbidity score was 5 center dot 3. A majority were white (82 center dot 0%) admitted to academic hospitals (69 center dot 5%) for elective procedures (55 center dot 7%). Inpatient mortality was 3 center dot 8%. The most common complication was fluid and electrolyte abnormalities (14 center dot 3%). Mean LOS was 8 center dot 5 days. In multivariate analysis, patients > 80 years old had 30% greater odds of death, relative to 65-69 year old counterparts. Each complication increased LOS by an average of at least 4 days. These associations were statistically significant (P-values < 0 center dot 05). Conclusions New clinically relevant risk stratification information is now available to assist clinicians in operative decision-making for elderly patients with pituitary tumour considering operative intervention.