Brain Tumours And Outcomes In A Nigerian Tertiary Hospital: A 5-Year Retrospective Review

Abstract

Background: Neurosurgery in resource-constrained settings is limited and fraught with enormous challenges which impact outcomes negatively. Although there is no absolute measure of quality surgical care, outcome measures of mortality, morbidity and length of hospital stay have been used universally to assess quality of care.
Methods: This is a retrospective review of brain tumours managed in a single tertiary, public institution between Jan 2017 and Jan 2022. Patient records were retrieved, demographic and treatment data was extracted with post operative follow-up for up to 6months. Outcome measures studied include length of ICU and hospital stays, neurologic deficits, re-operation and mortality rates. 
Results: During the period under review, 106 patients presented with intracranial tumours, 37 (34.9%) of these had acute presentations with hydrocephalus, seizures and altered mental status as the leading features, ages ranged from 22months to 74years. Seventy-eight (73%) patients had surgery. Sixty-two (79.5%) of the excised tumours were supratentorial and sixteen (20.5%) infratentorial. Sellar region tumours comprised 29.5%, meningiomas 26.9%, gliomas 25.6% and others 18%. Twelve patients had staged procedures with initial CSF diversion and later definitive surgery. Post operatively 10 (12.8%) patients had re-operations, mean length of ICU and hospital stay was 8days, and 14days respectively and mortality of 5%. At 6 months complete resolution of neurological deficits was observed in 52.5%, any improvement at all in 84.6% (66) and at least 2-line visual acuity improvement in 64.4%.
Conclusion: In spite of the limitations of neurosurgical care in resource-poor settings, surgery for brain tumours in these settings is associated with significant improvements in neurologic deficits and overall survival.