Comparación de escalas pronósticas en pacientes mayores de 65 años intervenidos de meningioma intracraneal. Nuestra experiencia entre 2002-2012 y revisión de la literatura / Comparison of intracranial meningioma outcome scales in operated patients older than 65 years old. Our experience between 2002-2012 and a literature review

Objetivo: Los meningiomas son los tumores intracraneales más frecuentes en el anciano. Su incidencia aumenta con la edad, por ello cada vez son diagnosticados con más frecuencia al incrementar la esperanza de vida. En nuestra muestra comparamos 4 escalas pronósticas: Clinical-Radiologic Grading System, Geriatric Scoring System, SKALE (Sexo, Karnofsky, ASA, localización y edema) y la escala de Charlson para analizar qué pacientes pueden beneficiarse de una cirugía. Material y métodos: Se realiza un análisis retrospectivo de 52 pacientes de edad mayor o igual a 65 años intervenidos en nuestro hospital desde el 2002 al 2012. Se recogen variables individuales y se aplican las 4 escalas buscando relación de ambos grupos con la mortalidad a los 3 meses y al año. Se utilizan los puntos de corte de cada una de las escalas y se determinan los valores predictivos positivo y negativo. Resultados: De las 4 escalas, solo la Clinical-Radiologic Grading System y la SKALE presentaron resultados estadísticamente significativos al analizar la mortalidad anual con los puntos de corte. Ninguna mostró relación con la mortalidad a los 3 meses. Sexo, edema, clínica previa y localización del tumor, no presentaron una relación estadísticamente significativa con la mortalidad. En cambio edad, tamaño y Karnofsky previo se correlacionaron significativamente con el pronóstico. Conclusión: Las escalas SKALE y Clinical-Radiologic Grading System son herramientas de fácil manejo que pueden ofrecer una visión orientativa sobre qué pacientes ancianos pueden beneficiarse de un tratamiento quirúrgico. Sin embargo, continúa teniendo gran importancia el análisis individualizado del paciente y la experiencia del neurocirujano

Objective: Meningioma is the most common intracranial tumor in the elderly. Its incidence rate increases with age; so as life expectancy increases, meningiomas are diagnosed more frequently. A comparison is made between 4 outcome scales in this study: Clinical-Radiological Grading System, Geriatric Scoring Scale, SKALE (Sex, Karnofsky, ASA, localization and edema), and the Charlson score, to analyze which patients could benefit from surgery. Materials and methods: A total of 52 patients of 65 years and older operated in our hospital between 2002 and 2012 were identified, and a retrospective analysis was performed. All individual variables were collected and applied the scales to see their relationship with 3 month and annual mortality. The critical values of each scale were applied and their positive and negative predictive values were calculated. Results: From the four scales, only the Clinical-Radiological Grading System and the SKALE had a significant statistical result when annual mortality was analyzed. None of them were associated with 3 month mortality. There was no statistically significant association between mortality and sex, edema, previous clinical history, and tumor location. But there was an association with age, tumor size and previous Karnofsky. Conclusion: The SKALE and the Clinical-Radiological Grading System are easy tools that can give an insight as regards patients who can benefit from a surgical treatment. Nevertheless, individualized patient analysis and neurosurgeon experience still have great importance

[Comparison of intracranial meningioma outcome scales in operated patients older than 65 years old. Our experience between 2002-2012 and a literature review]. / Comparación de escalas pronósticas en pacientes mayores de 65 años intervenidos de meningioma intracraneal. Nuestra experiencia entre 2002-2012 y revisión de la literatura.

OBJECTIVE: Meningioma is the most common intracranial tumor in the elderly. Its incidence rate increases with age; so as life expectancy increases, meningiomas are diagnosed more frequently. A comparison is made between 4 outcome scales in this study: Clinical-Radiological Grading System, Geriatric Scoring Scale, SKALE (Sex, Karnofsky, ASA, localization and edema), and the Charlson score, to analyze which patients could benefit from surgery. MATERIALS AND METHODS: A total of 52 patients of 65 years and older operated in our hospital between 2002 and 2012 were identified, and a retrospective analysis was performed. All individual variables were collected and applied the scales to see their relationship with 3 month and annual mortality. The critical values of each scale were applied and their positive and negative predictive values were calculated. RESULTS: From the four scales, only the Clinical-Radiological Grading System and the SKALE had a significant statistical result when annual mortality was analyzed. None of them were associated with 3 month mortality. There was no statistically significant association between mortality and sex, edema, previous clinical history, and tumor location. But there was an association with age, tumor size and previous Karnofsky. CONCLUSION: The SKALE and the Clinical-Radiological Grading System are easy tools that can give an insight as regards patients who can benefit from a surgical treatment. Nevertheless, individualized patient analysis and neurosurgeon experience still have great importance.