The epidemiology and outcome of patients admitted for elective brain tumour surgery at a single neurosurgical centre in South Africa

Introduction: Many countries, including South Africa, do not have a national brain tumour registry. Despite this limitation several institutional studies report age, gender, and histological tumour types that are in-line with the findings of the large established national brain tumour registries from the United States and Europe. Materials and methods: We conducted a prospective study consecutively enrolling all elective subjects admitted to our Unit with a neoplastic brain tumor from the 01 July 2018-31 March 2020. The data collected included age, gender, admission Glasgow Coma Score, HIV status, admission absolute CD4 count in all patients, radiological tumour diagnosis, pre-operative steroid treatment, length of in-hospital stay prior to surgery, time between prophylactic antibiotic administration and skin incision, intra-operative blood loss, length of surgery, extent of resection, histological diagnosis, post-operative nosocomial infection incidence, and Glasgow Outcome Score. Results: The mean age of our subjects was 48 (+/- 14.56) years. Significance was demonstrated between age and histological tumour diagnosis (p = 0.031). With regards gender 72/101 (72%) were males and 29/101 (29%) were females. Considering admission HIV status 65/101 (64%) were HIV negative and 36/101 (36%) were HIV positive. Of the 101 subjects enrolled in the study 78/101 (77%) were taken for operative intervention. The mean intra-operative blood loss in our study was 505 (+/- 336) millilitres. The mean length of surgery was 278 (+/- 80.33) minutes. Considering nosocomial infection 30/78 (38%) subjects developed this complication. Considering outcome 29/78 (37%) subjects in our study had a favourable outcome (GOS 4/5), and 49/78 (63%) had an unfavourable outcome (GOS 1-3). Conclusion: Patients with brain tumours, whether HIV positive or not, show characteristic histological tumour types that are age specific. While being HIV positive does have a detrimental influence, the primary histology of the lesion and the extent of resection are the major determinants of outcome.