Evidence map›Paper›PMID 36324951›Full record

ArticleSurgical neurology international2022

Advanced frailty assessment tool predicts successful awake craniotomy in a 92-year-old patient: A case report.

Kyril L Cole, Samantha Varela, Kavelin Rumalla, Syed Faraz Kazim, Ryan W Rebbe, Michael Carvajal, Karen S SantaCruz, Rohini McKee, Cheryl Willman, Meic H Schmidt and 1 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical neurology international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kyril L ColeDepartment of Neurosurgery, University of New Mexico, University of New Mexico Health Sciences Center, Albuquerque, United States.
Samantha VarelaDepartment of Neurosurgery, University of New Mexico, University of New Mexico Health Sciences Center, Albuquerque, United States.
Kavelin RumallaDepartment of Neurosurgery, University of New Mexico, University of New Mexico Health Sciences Center, Albuquerque, United States.
Syed Faraz KazimDepartment of Neurosurgery, University of New Mexico, University of New Mexico Health Sciences Center, Albuquerque, United States.
Ryan W RebbeDepartment of Neurosurgery, University of New Mexico, University of New Mexico Health Sciences Center, Albuquerque, United States.
Michael CarvajalDepartment of Neurosurgery, University of New Mexico, University of New Mexico Health Sciences Center, Albuquerque, United States.
Karen S SantaCruzDepartment of Neurosurgery, University of New Mexico, University of New Mexico Health Sciences Center, Albuquerque, United States.
Rohini McKeeDepartment of Neurosurgery, University of New Mexico, University of New Mexico Health Sciences Center, Albuquerque, United States.
Cheryl WillmanDepartment of Neurosurgery, University of New Mexico, University of New Mexico Health Sciences Center, Albuquerque, United States.
Meic H SchmidtDepartment of Neurosurgery, University of New Mexico, University of New Mexico Health Sciences Center, Albuquerque, United States.
Christian A BowersDepartment of Neurosurgery, University of New Mexico, University of New Mexico Health Sciences Center, Albuquerque, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The awake craniotomy (AC) procedure allows for safe and maximal resection of brain tumors from highly eloquent regions. However, geriatric patients are often viewed as poor candidates for AC due to age and medical comorbidities. Frailty assessments gauge physiological reserve for surgery and are valuable tools for preoperative decision-making. Here, we present a novel case illustrating how frailty scoring enabled an elderly but otherwise healthy female to undergo successful AC for tumor resection. Case Description: A 92-year-old right-handed female with history of hypertension and basal cell skin cancer presented with a 1-month history of progressive aphasia and was found to have a ring-enhancing left frontoparietal mass abutting the rolandic cortex concerning for malignant neoplasm. Frailty scoring with the recalibrated risk analysis index (RAI-C) tool revealed a score of 30 (of 81) indicating low surgical risk. The patient and family were counseled appropriately that, despite advanced chronological age, a low frailty score predicts favorable surgical outcomes. The patient underwent left-sided AC for resection of tumor and experienced immediate improvement of speech intraoperatively. After surgery, the patient was neurologically intact and had an unremarkable postoperative course with significant improvements from preoperatively baseline at follow-up. Conclusion: To the best of our knowledge, this case represents the oldest patient to undergo successful AC for brain tumor resection. Nonfrail patients over 90 years of age with the proper indications may tolerate cranial surgery. Frailty scoring is a powerful tool for preoperative risk assessment in the geriatric neurosurgery population.

Indexed as

Awake craniotomyFrailtyMalignant tumorRisk analysis indexTumor resection

Identifiers

PMID36324951
PMCPMC9610602

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