Discussion

Introduction: Hypoalbuminemia, a surrogate for malnutrition, has been associated with higher rates of postoperative complications. However, comprehensive analysis of the impact of malnutrition on postoperative outcomes and long-term outcomes following supratentorial or infratentorial meningioma resection has not been performed. Here, we investigate the relationship between malnutrition and surgical outcomes/complications in meningioma resection.

Methods: We conducted a propensity-matched cohort study using data from 60 US healthcare organizations with the TriNetX database. Patients aged 18 to 90 years old with serum albumin collected within 4 months of surgery were included to compare the outcomes following meningioma resection: Cohort A – Malnourished(albumin < 3.50 g/dL) composed of 1,005 patients and Cohort B – Nourished (albumin≥ 3.50g/dL) composed of 4,218 patients. Propensity matched analysis was conducted based on demographics, yielding 990 patients in each cohort, complication rates were then compared at 24 hours, 30 days, and 90

Results: Our analysis revealed that hypoalbuminemic patients who underwent supratentorial or infratentorial meningioma resection had poorer surgical outcomes and increased complications compared to their nourished counterparts. Patients who were malnourished experienced a greater risk of 1-month(38.4% vs. 30.2%, p< 0.001) and 3-month(42.5% vs. 33.6%, p< 0.001) readmission compared to those who were not. Malnourished patients were significantly more likely to experience postoperative complications one month postoperatively, including sepsis(10.4% vs. 6.7%, p=0.003), new onset seizures(10.5% vs. 5.5%, p=0.001), UTIs(8.7% vs. 5.1%, p=0.001), ventilator use(7.7% vs. 4.6%, p=0.005), acute pulmonary failure(4.9% vs. 2.3%, p=0.01), emergency intubation(3.8% vs. 2.2%, p=0.036), and nontraumatic hemorrhage(7.7% vs. 4.2%, p=0.001). These results were also significant at 3-months post-op. Malnourished patients experienced higher rates of mortality(7.9% vs. 3.6%, p< 0.001).

Conclusion : Hypoalbuminemia, a marker for malnutrition, is associated with statistically significant increase rates of postoperative complications following meningioma resection. Our data support further investigation of hypoalbuminemia on postoperative meningioma resection outcomes and the prospective evaluation of nutritional optimization in meningioma resection.