Morbidity and Mortality of Major Cranial Surgery: An Institutional Based Prospective Observational Study

Abstract

INTRODUCTION: Surgical complications are often broadly defined as “any deviation from the normal postoperative course.” This definition is clearly subjective and prone to inter-observer variability. It’s our first attempt to identify the post-operative status of the patients who underwent major cranial surgery in terms of morbidity and mortality and find out the preventable cause.

METHOD: This was a prospective study carried out at National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal. The patients of all age group who underwent cranial surgeries were included in the study. We analyzed post-operative neurological status and complications in terms of morbidity and mortality.

RESULT: Total of 405 cranial surgeries were carried out on 364 patients. About two-thirds of the patients (62%) were male and 38% were female.Of the cranial surgery, 133 were for brain tumors, 67 were for traumatic brain injuries, 64 were for vascular lesions, 18 were for congenital disorders and 17 were for infective diseases. Post-operative complication was noted in 27.7%. Among various complications, 13% had pulmonary complications, 5% had new onset seizures, 3% had infarctions and 2.5% had major neurologic deficits. Overall mortality rate was 11%.

CONCLUSION: Pulmonary complication is the most common complication after major cranial surgery, which is one of the preventable causes of morbidity and mortality.