Matched analysis of patient gender and meningioma resection outcomes

Abstract

Purpose

Gender is a known social determinant of health (SDOH) that has been linked to neurosurgical outcome disparities. To improve quality of care, there exists a need to investigate the impact of gender on procedure-specific outcomes. The objective of this study was to assess the role of gender on short- and long-term outcomes following resection of meningiomas – the most common benign brain neoplasm of adulthood – between exact matched patient cohorts.

Material and Methods

All consecutive patients undergoing supratentorial meningioma resection (n = 349) at a single, university-wide health system over a 6-year period were analyzed retrospectively. Coarsened exact matching was employed to match patients on numerous key characteristics related to outcomes. Primary outcomes included readmission, ED visit, reoperation, and mortality within 30 and 90 days of surgery. Mortality and reoperation were also assessed during the entire follow-up period. Outcomes were compared between matched female and male cohorts.

Results

Between matched cohorts, no significant difference was observed in morbidity or mortality at 30 days (p = 0.42–0.75), 90-days (p = 0.23–0.69), or throughout the follow-up period (p = 0.22–0.45). Differences in short-term mortality could not be assessed due to the low number of mortality events.

Conclusions

After matching on characteristics known to impact outcomes and when isolated from other SDOHs, gender does not independently affect morbidity and mortality following meningioma resection. Further research on the role of other SDOHs in this population is merited to better understand underlying drivers of disparity.

Keywords:

• Gender
• benign brain neoplasm
• outcomes
• readmission
• social disparity

Ethical approval

This study was approved by the IRB at the University of Pennsylvania. IRB number for this study is: 832794. A waiver of informed consent was granted by the University of Pennsylvania IRB as this study was considered to be minimal risk to patients. All ethical guidelines and rules were followed to protect patient privacy.

Disclosure statement

The authors have no personal or institutional interest with regard to the authorship and/or publication of this manuscript. 

Author contributions

SH and NRM were involved in the design and conception of this manuscript. SDH, AJB, and NRM performed the literature review and compiled the primary manuscript. SDH, SK, AJB, RD, KS, SDM, and NRM collected and analyzed data. SDH, AJB, RD, and NRM compiled the figures and tables. SDH, SK, AJB, RD, KS, NMA, SDM, and NRM critically revised the manuscript. All authors approved the manuscript as it is written.

Additional information

Funding

This research received no specific grant from any funding agency in the public or commercial or sectors. Support was received from the Kevin and Bernadette McKenna Family Research Fund. Dr. Neil R Malhotra receives funding from The Bernadette and Kevin McKenna Family Research Fund.