2026 Proffered Presentations
S149: IMPACT OF OBESITY ON POSTOPERATIVE OUTCOMES IN CEREBRAL MENINGIOMA RESECTION: A PROPENSITY-MATCHED TRINETX ANALYSIS
Alexander Velasquez, BS1; Miguel Lopez-Gonzalez, MD2; 1UC Riverside School of Medicine; 2Loma Linda University Health: Department of Neurosurgery
Background: Meningiomas are the most common primary intracranial tumors and account for approximately one-third of all central nervous system tumors. Although often histologically benign, surgical resection carries a measurable risk of perioperative morbidity, which can impact recovery and long-term outcomes. With prevalence rates approaching 40% in the United States, obesity has become one of the most common comorbidities encountered in surgical patients. However, the influence of obesity on postoperative complications following cerebral meningioma resection has not been well characterized. Thus, understanding this relationship can help teams anticipate complications and adjust perioperative planning for obese patients undergoing resection.
Methods: A retrospective cohort study was conducted using the TriNetX Research Network. Adult patients (≥18 years) with a diagnosis of benign cerebral meningioma (ICD-10: D32.0) who underwent surgical resection on or after January 1, 2010, were identified. Surgical intervention was defined by CPT codes for excision of supratentorial meningioma via craniotomy (61512), resection of infratentorial/posterior fossa meningioma (61510), and related meningioma-specific procedures. Patients were stratified into two cohorts: those with a documented diagnosis of obesity (ICD-10: E66) and those without obesity. Exclusion criteria included malignant neoplasms of the meninges or cerebral meninges, as well as benign spinal neoplasms. Propensity score matching was performed in a 1:1 ratio between obese and non-obese cohorts. Matching variables included age at index, sex, type 2 diabetes mellitus (E11), hypertension (I10), nicotine dependence (F17), tobacco use (Z72.0), personal history of nicotine dependence (Z87.891), chronic kidney disease (N18), and chronic ischemic heart disease (I25). The primary outcomes were postoperative complications within a 90-day postoperative window, including deep vein thrombosis (DVT), seizures, cerebrospinal fluid (CSF) leakage, postoperative infections, intracranial hemorrhage, sepsis, and encephalopathy (toxic, metabolic, and unspecified). Event incidence was compared between cohorts using risk ratios (RR).
Results: After propensity score matching, each cohort consisted of 4,087 patients, totaling 8,174 patients across both cohorts. Incidence of DVT (3.26% vs. 1.75%; RR: 1.87; p < 0.0001), sepsis (1.41% vs. 0.90%; RR: 1.57; p = 0.0317), and toxic encephalopathy (0.52% vs. 0.25%; RR: 2.12; p = 0.0461) was significantly higher in the obese cohort. No statistically significant differences were observed for seizures, CSF leakage, postoperative infections, intracranial hemorrhage, or encephalopathy (metabolic and unspecified).
Conclusion: Our findings demonstrate that obesity is associated with a higher risk of postoperative DVT, sepsis, and toxic encephalopathy when undergoing cerebral meningioma resection, while most other complications were comparable between obese and non-obese patients. These results suggest that obesity may selectively influence certain postoperative risks without affecting complication rates broadly. Future work should examine how obesity interacts with factors such as diabetes, smoking, and cardiovascular disease to influence surgical risk.