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New predictors of complications in carotid body tumor resection

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New predictors of complications in carotid body tumor resection. / Kim, Gloria Y; Lawrence, Peter F; Moridzadeh, Rameen S; Zimmerman, Kate; Munoz, Alberto; Luna-Ortiz, Kuauhyama; Oderich, Gustavo S; de Francisco, Juan; Ospina, Jorge; Huertas, Santiago; de Souza, Leonardo R; Bower, Thomas C; Farley, Steven; Gelabert, Hugh A; Kret, Marcus R; Harris, E John; De Caridi, Giovanni; Spinelli, Francesco; Smeds, Matthew R; Liapis, Christos D; Kakisis, John; Papapetrou, Anastasios P; Debus, Eike S; Behrendt, Christian-A; Kleinspehn, Edgar; Horton, Joshua D; Mussa, Firas F; Cheng, Stephen W K; Morasch, Mark D; Rasheed, Khurram; Bennett, Matthew E; Bismuth, Jean; Lumsden, Alan B; Abularrage, Christopher J; Farber, Alik.

in: J VASC SURG, Jahrgang 65, Nr. 6, 06.2017, S. 1673-1679.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Kim, GY, Lawrence, PF, Moridzadeh, RS, Zimmerman, K, Munoz, A, Luna-Ortiz, K, Oderich, GS, de Francisco, J, Ospina, J, Huertas, S, de Souza, LR, Bower, TC, Farley, S, Gelabert, HA, Kret, MR, Harris, EJ, De Caridi, G, Spinelli, F, Smeds, MR, Liapis, CD, Kakisis, J, Papapetrou, AP, Debus, ES, Behrendt, C-A, Kleinspehn, E, Horton, JD, Mussa, FF, Cheng, SWK, Morasch, MD, Rasheed, K, Bennett, ME, Bismuth, J, Lumsden, AB, Abularrage, CJ & Farber, A 2017, 'New predictors of complications in carotid body tumor resection', J VASC SURG, Jg. 65, Nr. 6, S. 1673-1679. https://doi.org/10.1016/j.jvs.2016.12.124

APA

Kim, G. Y., Lawrence, P. F., Moridzadeh, R. S., Zimmerman, K., Munoz, A., Luna-Ortiz, K., Oderich, G. S., de Francisco, J., Ospina, J., Huertas, S., de Souza, L. R., Bower, T. C., Farley, S., Gelabert, H. A., Kret, M. R., Harris, E. J., De Caridi, G., Spinelli, F., Smeds, M. R., ... Farber, A. (2017). New predictors of complications in carotid body tumor resection. J VASC SURG, 65(6), 1673-1679. https://doi.org/10.1016/j.jvs.2016.12.124

Vancouver

Kim GY, Lawrence PF, Moridzadeh RS, Zimmerman K, Munoz A, Luna-Ortiz K et al. New predictors of complications in carotid body tumor resection. J VASC SURG. 2017 Jun;65(6):1673-1679. https://doi.org/10.1016/j.jvs.2016.12.124

Bibtex

@article{0d6b5d308b324800a6628f639e298f41,
title = "New predictors of complications in carotid body tumor resection",
abstract = "OBJECTIVE: This study examined the relationship between two new variables, tumor distance to base of skull (DTBOS) and tumor volume, with complications of carotid body tumor (CBT) resection, including bleeding and cranial nerve injury.METHODS: Patients who underwent CBT resection between 2004 and 2014 were studied using a standardized, multi-institutional database. Demographic, perioperative, and outcomes data were collected. CBT measurements were determined from computed tomography, magnetic resonance imaging, and ultrasound examination.RESULTS: There were 356 CBTs resected in 332 patients (mean age, 51 years; 72% female); 32% were classified as Shamblin I, 43% as Shamblin II, and 23% as Shamblin III. The mean DTBOS was 3.3 cm (standard deviation [SD], 2.1; range, 0-10), and the mean tumor volume was 209.7 cm3 (SD, 266.7; range, 1.1-1642.0 cm3). The mean estimated blood loss (EBL) was 257 mL (SD, 426; range, 0-3500 mL). Twenty-four percent of patients had cranial nerve injuries. The most common cranial nerves injured were the hypoglossal (10%), vagus (11%), and superior laryngeal (5%) nerves. Both Shamblin grade and DTBOS were statistically significantly correlated with EBL of surgery and cranial nerve injuries, whereas tumor volume was statistically significantly correlated with EBL. The logistic model for predicting blood loss and cranial nerve injury with all three variables-Shamblin, DTBOS, and volume (R2 = 0.171, 0.221, respectively)-was superior to a model with Shamblin alone (R2 = 0.043, 0.091, respectively). After adjusting for Shamblin grade and volume, every 1-cm decrease in DTBOS was associated with 1.8 times increase in risk of >250 mL of blood loss (95% confidence interval, 1.25-2.55) and 1.5 times increased risk of cranial nerve injury (95% confidence interval, 1.19-1.92).CONCLUSIONS: This large study of CBTs demonstrates the value of preoperatively determining tumor dimensions and how far the tumor is located from the base of the skull. DTBOS and tumor volume, when used in combination with the Shamblin grade, better predict bleeding and cranial nerve injury risk. Furthermore, surgical resection before expansion toward the base of the skull reduces complications as every 1-cm decrease in the distance to the skull base results in 1.8 times increase in >250 mL of blood loss and 1.5 times increased risk of cranial nerve injury.",
keywords = "Adult, Aged, Aged, 80 and over, Anatomic Landmarks, Blood Loss, Surgical, Brazil, Carotid Body Tumor/complications, Colombia, Computed Tomography Angiography, Cranial Nerve Injuries/diagnosis, Databases, Factual, Europe, Female, Hong Kong, Humans, Logistic Models, Magnetic Resonance Angiography, Male, Mexico, Middle Aged, Odds Ratio, Retrospective Studies, Risk Assessment, Risk Factors, Skull Base/diagnostic imaging, Treatment Outcome, Tumor Burden, Ultrasonography, United States, Vascular Surgical Procedures/adverse effects, Young Adult",
author = "Kim, {Gloria Y} and Lawrence, {Peter F} and Moridzadeh, {Rameen S} and Kate Zimmerman and Alberto Munoz and Kuauhyama Luna-Ortiz and Oderich, {Gustavo S} and {de Francisco}, Juan and Jorge Ospina and Santiago Huertas and {de Souza}, {Leonardo R} and Bower, {Thomas C} and Steven Farley and Gelabert, {Hugh A} and Kret, {Marcus R} and Harris, {E John} and {De Caridi}, Giovanni and Francesco Spinelli and Smeds, {Matthew R} and Liapis, {Christos D} and John Kakisis and Papapetrou, {Anastasios P} and Debus, {Eike S} and Christian-A Behrendt and Edgar Kleinspehn and Horton, {Joshua D} and Mussa, {Firas F} and Cheng, {Stephen W K} and Morasch, {Mark D} and Khurram Rasheed and Bennett, {Matthew E} and Jean Bismuth and Lumsden, {Alan B} and Abularrage, {Christopher J} and Alik Farber",
note = "Copyright {\textcopyright} 2017. Published by Elsevier Inc.",
year = "2017",
month = jun,
doi = "10.1016/j.jvs.2016.12.124",
language = "English",
volume = "65",
pages = "1673--1679",
journal = "J VASC SURG",
issn = "0741-5214",
publisher = "Mosby Inc.",
number = "6",

}

RIS

TY - JOUR

T1 - New predictors of complications in carotid body tumor resection

AU - Kim, Gloria Y

AU - Lawrence, Peter F

AU - Moridzadeh, Rameen S

AU - Zimmerman, Kate

AU - Munoz, Alberto

AU - Luna-Ortiz, Kuauhyama

AU - Oderich, Gustavo S

AU - de Francisco, Juan

AU - Ospina, Jorge

AU - Huertas, Santiago

AU - de Souza, Leonardo R

AU - Bower, Thomas C

AU - Farley, Steven

AU - Gelabert, Hugh A

AU - Kret, Marcus R

AU - Harris, E John

AU - De Caridi, Giovanni

AU - Spinelli, Francesco

AU - Smeds, Matthew R

AU - Liapis, Christos D

AU - Kakisis, John

AU - Papapetrou, Anastasios P

AU - Debus, Eike S

AU - Behrendt, Christian-A

AU - Kleinspehn, Edgar

AU - Horton, Joshua D

AU - Mussa, Firas F

AU - Cheng, Stephen W K

AU - Morasch, Mark D

AU - Rasheed, Khurram

AU - Bennett, Matthew E

AU - Bismuth, Jean

AU - Lumsden, Alan B

AU - Abularrage, Christopher J

AU - Farber, Alik

N1 - Copyright © 2017. Published by Elsevier Inc.

PY - 2017/6

Y1 - 2017/6

N2 - OBJECTIVE: This study examined the relationship between two new variables, tumor distance to base of skull (DTBOS) and tumor volume, with complications of carotid body tumor (CBT) resection, including bleeding and cranial nerve injury.METHODS: Patients who underwent CBT resection between 2004 and 2014 were studied using a standardized, multi-institutional database. Demographic, perioperative, and outcomes data were collected. CBT measurements were determined from computed tomography, magnetic resonance imaging, and ultrasound examination.RESULTS: There were 356 CBTs resected in 332 patients (mean age, 51 years; 72% female); 32% were classified as Shamblin I, 43% as Shamblin II, and 23% as Shamblin III. The mean DTBOS was 3.3 cm (standard deviation [SD], 2.1; range, 0-10), and the mean tumor volume was 209.7 cm3 (SD, 266.7; range, 1.1-1642.0 cm3). The mean estimated blood loss (EBL) was 257 mL (SD, 426; range, 0-3500 mL). Twenty-four percent of patients had cranial nerve injuries. The most common cranial nerves injured were the hypoglossal (10%), vagus (11%), and superior laryngeal (5%) nerves. Both Shamblin grade and DTBOS were statistically significantly correlated with EBL of surgery and cranial nerve injuries, whereas tumor volume was statistically significantly correlated with EBL. The logistic model for predicting blood loss and cranial nerve injury with all three variables-Shamblin, DTBOS, and volume (R2 = 0.171, 0.221, respectively)-was superior to a model with Shamblin alone (R2 = 0.043, 0.091, respectively). After adjusting for Shamblin grade and volume, every 1-cm decrease in DTBOS was associated with 1.8 times increase in risk of >250 mL of blood loss (95% confidence interval, 1.25-2.55) and 1.5 times increased risk of cranial nerve injury (95% confidence interval, 1.19-1.92).CONCLUSIONS: This large study of CBTs demonstrates the value of preoperatively determining tumor dimensions and how far the tumor is located from the base of the skull. DTBOS and tumor volume, when used in combination with the Shamblin grade, better predict bleeding and cranial nerve injury risk. Furthermore, surgical resection before expansion toward the base of the skull reduces complications as every 1-cm decrease in the distance to the skull base results in 1.8 times increase in >250 mL of blood loss and 1.5 times increased risk of cranial nerve injury.

AB - OBJECTIVE: This study examined the relationship between two new variables, tumor distance to base of skull (DTBOS) and tumor volume, with complications of carotid body tumor (CBT) resection, including bleeding and cranial nerve injury.METHODS: Patients who underwent CBT resection between 2004 and 2014 were studied using a standardized, multi-institutional database. Demographic, perioperative, and outcomes data were collected. CBT measurements were determined from computed tomography, magnetic resonance imaging, and ultrasound examination.RESULTS: There were 356 CBTs resected in 332 patients (mean age, 51 years; 72% female); 32% were classified as Shamblin I, 43% as Shamblin II, and 23% as Shamblin III. The mean DTBOS was 3.3 cm (standard deviation [SD], 2.1; range, 0-10), and the mean tumor volume was 209.7 cm3 (SD, 266.7; range, 1.1-1642.0 cm3). The mean estimated blood loss (EBL) was 257 mL (SD, 426; range, 0-3500 mL). Twenty-four percent of patients had cranial nerve injuries. The most common cranial nerves injured were the hypoglossal (10%), vagus (11%), and superior laryngeal (5%) nerves. Both Shamblin grade and DTBOS were statistically significantly correlated with EBL of surgery and cranial nerve injuries, whereas tumor volume was statistically significantly correlated with EBL. The logistic model for predicting blood loss and cranial nerve injury with all three variables-Shamblin, DTBOS, and volume (R2 = 0.171, 0.221, respectively)-was superior to a model with Shamblin alone (R2 = 0.043, 0.091, respectively). After adjusting for Shamblin grade and volume, every 1-cm decrease in DTBOS was associated with 1.8 times increase in risk of >250 mL of blood loss (95% confidence interval, 1.25-2.55) and 1.5 times increased risk of cranial nerve injury (95% confidence interval, 1.19-1.92).CONCLUSIONS: This large study of CBTs demonstrates the value of preoperatively determining tumor dimensions and how far the tumor is located from the base of the skull. DTBOS and tumor volume, when used in combination with the Shamblin grade, better predict bleeding and cranial nerve injury risk. Furthermore, surgical resection before expansion toward the base of the skull reduces complications as every 1-cm decrease in the distance to the skull base results in 1.8 times increase in >250 mL of blood loss and 1.5 times increased risk of cranial nerve injury.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Anatomic Landmarks

KW - Blood Loss, Surgical

KW - Brazil

KW - Carotid Body Tumor/complications

KW - Colombia

KW - Computed Tomography Angiography

KW - Cranial Nerve Injuries/diagnosis

KW - Databases, Factual

KW - Europe

KW - Female

KW - Hong Kong

KW - Humans

KW - Logistic Models

KW - Magnetic Resonance Angiography

KW - Male

KW - Mexico

KW - Middle Aged

KW - Odds Ratio

KW - Retrospective Studies

KW - Risk Assessment

KW - Risk Factors

KW - Skull Base/diagnostic imaging

KW - Treatment Outcome

KW - Tumor Burden

KW - Ultrasonography

KW - United States

KW - Vascular Surgical Procedures/adverse effects

KW - Young Adult

U2 - 10.1016/j.jvs.2016.12.124

DO - 10.1016/j.jvs.2016.12.124

M3 - SCORING: Journal article

C2 - 28527929

VL - 65

SP - 1673

EP - 1679

JO - J VASC SURG

JF - J VASC SURG

SN - 0741-5214

IS - 6

ER -