Abstract

Objective: To evaluate the feasibility of GCS and SKALE in predicting post-operative requirement of ventilator support in intracranial tumour patients.

Methods: Seventy patients undergoing intracranial tumour resection surgery were assessed pre-operatively using GCS and SKALE scoring systems to predict their post-operative requirement of ventilator support. The data was analysed using SPSS software and ShapiroWilk test and Chi-Square tests were apllied to compare the obtain data.

Results: The study included 70 patients, of whom 88.6% had good GCS of 13-15 and 72.9% had good SKALE score of >8. We found that all patients with poor GCS ≤8 required post -operative ventilator support, while only 4 out 62 patients with GCS 13-15 required ventilator support post-operatively (p value <0.05). Patients with SKALE score ≤8 also had higher incidence of post-operative ventilator requirement (31.6%) as against those with SKALE score >8 (11.8%).

Conclusion: GCS is a good predictor of post-operative ventilator requirement. SKALE scoring system requires further studies to prove its utility.

• 1.   Reponen E, Tuominen H, Korja M. Evidence for the Use of Preoperative Risk Assessment Scores in Elective Cranial Neurosurgery. Anesth Analg. 2014 Aug;119(2):420–32.
• 2.   Sacko O, Sesay M, Roux FE, Riem T, Grenier B, Liguoro D, et al. Intracranial meningioma surgery in the ninth decade of life. Neurosurgery. 2007 Nov;61(5):950–4.
• 3.   Fu KG, Smith JS, Polly DW, Ames CP, Berven SH, Perra JH, et al. Correlation of higher pre-operative American Society of Anaesthesiology grade and increased morbidity and mortality rates in patients undergoing spine surgery. J Neurosurg Spine. 2011 Apr;14(4):470–4.
• 4.   Delgado-Fernández J, García-Pallero MA, Gil-Simoes R, Blasco G, Frade-Porto N, Pulido P, et al. Validation of Grading Scores and Outcome Prognostic Factors in Intracranial Meningiomas in Elderly Patients. World Neurosurg. 2018 Jun;114:e1057–65.
• 5.   Yamamoto J, Takahashi M, Idei M, Nakano Y, Soejima Y, Akiba D, et al. Clinical features and surgical management of intracranial meningiomas in the elderly. Oncol Lett. 2017 Jul;14(1):909–17.
• 6.   Noordzij PG, Poldermans D, Schouten O, Bax JJ, Schreiner FA, Boersma E. Postoperative mortality in The Netherlands: A population-based analysis of surgery-specific risk in adults. Anesthesiology. 2010 May;112(5):1105–15.
• 7.   Manninen PH, Raman SK, Boyle K, el-Beheiry H. Early post-operative complications following neurosurgical procedures. Can J Anaesth. 1999 Jan;46(1):7–14.
• 8.   Cinotti R, Bruder N, Srairi M, Paugam-Burtz C, Beloeil H, Pottecher J, et al. Prediction score for postoperative neurologic complications after brain tumour craniotomy: a multicenter observational study. Anesthesiology. 2018 Dec;129(6):1111–20.
• 9.   Bindra A, Bharadwaj S, Mishra N, Masapu D, Bhargava S, Luthra A, et al. Preanesthetic Evaluation and Preparation for Neurosurgical Procedures: An Indian Perspective. J Neuroanaesthesiol Crit Care. 2022 Jun;9(2):84–92.
• 10.   Zhao Z, Zhang X, Song C, Zhao J, Gao Q, Jiang W. A Novel INCNS Score for Prediction of Mortality and Functional Outcome of Comatose Patients. Front Neurol. 2021 Jan 15;11:585818.
• 11.   D'Andrea G, Roperto R, Caroli E, Crispo F, Ferrante L. Thirty-seven cases of intracranial meningiomas in the ninth decade of life: our experience and review of the literature. Neurosurgery. 2005 May;56(5):956–61.
• 12.   Song X, Zeng C, Wang M, Wang W, Lin F, He Q, et al. Clinical characteristics and risk factors of perioperative outcomes in elderly patients with intracranial tumours. Neurosurg Rev. 2021 Feb;44(1):389–400.

Data Sharing Statement

Funding