人口结构的变化将导致老年患者的增加，这些患者术后发病和死亡的风险很高，需要对脑膜瘤进行神经外科手术。这项多中心研究旨在报告 80 岁或以上幕上脑膜瘤患者切除后的神经功能状态，以确定与结果相关的因素，并验证先前提出的决策支持工具。神经功能状态通过卡诺夫斯基表现量表 (KPS) 进行评估。术前将患者分为差（KPS ≤ 40）、中（KPS 50-70）和好（KPS ≥ 80）亚组。对肿瘤和瘤周脑水肿（PTBE）进行体积分析；体积分为小（<10 cm3）、中（10-50 cm3）和大（>50 cm3）。研究人群由 262 名患者组成，手术时中位年龄为 83.0 岁。术前 KPS 中位数为 70； 117 名患者（44.7%）被分配到良好亚组，113 名患者（43.1%）被分配到中等亚组，32 名患者（12.2%）被分配到较差亚组。肿瘤和 PTBE 的中位体积分别为 30.2 cm3 和 27.3 cm3；较大的 PTBE 体积与不良的术前 KPS 状态相关 (P = .008)。 90天和1年死亡率分别为9.0%和13.2%。术后第一年内，101 名（38.5%）患者病情有所改善，87 名（33.2%）患者没有变化，74 名（28.2%）患者功能恶化（包括死亡）。年龄每年增加 90 天和 1 年死亡率风险增加 44% (23%-70%)。总共有 111 名 (42.4%) 患者出现手术相关并发症。最大肿瘤直径≥5 cm（比值比1.87 [1.12-3.13]）和大肿瘤体积（比值比2.35 [1.01-5.50]）与并发症风险增加相关。术前神经功能状态较差且PTBE较大的患者中，大多数（58.3%）从手术中受益。术前神经功能状态较差且PTBE较大的患者术后最常出现改善。决策支持工具可能有助于识别最有可能从手术中受益的病例。版权所有 © 神经外科医生大会 2023。保留所有权利。

Demographic changes will lead to an increase in old patients, a population with significant risk of postoperative morbidity and mortality, requiring neurosurgery for meningiomas. This multicenter study aims to report neurofunctional status after resection of patients with supratentorial meningioma aged 80 years or older, to identify factors associated with outcome, and to validate a previously proposed decision support tool.Neurofunctional status was assessed by the Karnofsky Performance Scale (KPS). Patients were categorized in poor (KPS ≤40), intermediate (KPS 50-70), and good (KPS ≥80) preoperative subgroups. Volumetric analyses of tumor and peritumoral brain edema (PTBE) were performed; volumes were scored as small (<10 cm3), medium (10-50 cm3), and large (>50 cm3).The study population consisted of 262 patients, and the median age at surgery was 83.0 years. The median preoperative KPS was 70; 117 (44.7%) patients were allotted to the good, 113 (43.1%) to the intermediate, and 32 (12.2%) to the poor subgroup. The median tumor and PTBE volumes were 30.2 cm3 and 27.3 cm3; large PTBE volume correlated with poor preoperative KPS status (P = .008). The 90-day and 1-year mortality rates were 9.0% and 13.2%, respectively. Within the first postoperative year, 101 (38.5%) patients improved, 87 (33.2%) were unchanged, and 74 (28.2%) were functionally worse (including deaths). Each year increase of age associated with 44% (23%-70%) increased risk of 90-day and 1-year mortality. In total, 111 (42.4%) patients suffered from surgery-associated complications. Maximum tumor diameter ≥5 cm (odds ratio 1.87 [1.12-3.13]) and large tumor volume (odds ratio 2.35 [1.01-5.50]) associated with increased risk of complications. Among patients with poor preoperative status and large PTBE, most (58.3%) benefited from surgery.Patients with poor preoperative neurofunctional status and large PTBE most often showed postoperative improvements. The decision support tool may be of help in identifying cases that most likely benefit from surgery.Copyright © Congress of Neurological Surgeons 2023. All rights reserved.