A Decision Analysis Tool for the Assessment of Posterior Fossa Tumour Surgery Outcomes in Children--the "Liverpool Neurosurgical Complication Causality Assessment Tool"

Overview

Journal Childs Nerv Syst

Specialty Pediatrics

Date 2013 Mar 16

PMID 23494657

Citations 1

Authors

Rasheed Zakaria

Jonathan Ellenbogen

Catherine Graham

Barry Pizer

Conor Mallucci

Ram Kumar

Affiliations

Soon will be listed here.

Abstract

Introduction: Complications may occur following posterior fossa tumour surgery in children. Such complications are subjectively and inconsistently reported even though they may have significant long-term behavioural and cognitive consequences for the child. This makes comparison of surgeons, programmes and treatments problematic.

Materials And Methods: We have devised a causality tool for assessing if an adverse event after surgery can be classified as a surgical complication using a series of simple questions, based on a tool used in assessing adverse drug reactions. This tool, which we have called the "Liverpool Neurosurgical Complication Causality Assessment Tool", was developed by reviewing a series of ten posterior fossa tumour cases with a panel of neurosurgery, neurology, oncology and neuropsychology specialists working in a multidisciplinary paediatric tumour treatment programme.

Discussion And Conclusion: We have demonstrated its use and hope that it may improve reliability between different assessors both in evaluating the outcomes of existing programmes and treatments as well as aiding in trials which may directly compare the effects of surgical and medical treatments.

Citing Articles

Pediatric medulloblastoma - update on molecular classification driving targeted therapies.

deSouza R, Jones B, Lowis S, Kurian K Front Oncol. 2014; 4:176.

PMID: 25101241 PMC: 4105823. DOI: 10.3389/fonc.2014.00176.

References

Shanmugam G, Clark L, Burton H, Warren A, OBlenes S, Hancock Friesen C . Improving and standardizing capture of pediatric cardiac surgical complications. J Thorac Cardiovasc Surg. 2012; 144(3):570-6. DOI: 10.1016/j.jtcvs.2012.01.070. View

Ozgur B, Berberian J, Aryan H, Meltzer H, Levy M . The pathophysiologic mechanism of cerebellar mutism. Surg Neurol. 2006; 66(1):18-25. DOI: 10.1016/j.surneu.2005.12.003. View

Di Rocco C, Chieffo D, Pettorini B, Massimi L, Caldarelli M, Tamburrini G . Preoperative and postoperative neurological, neuropsychological and behavioral impairment in children with posterior cranial fossa astrocytomas and medulloblastomas: the role of the tumor and the impact of the surgical treatment. Childs Nerv Syst. 2010; 26(9):1173-88. DOI: 10.1007/s00381-010-1166-2. View

Orgel E, Jain S, Ji L, Pollick L, Si S, Finlay J . Hearing loss among survivors of childhood brain tumors treated with an irradiation-sparing approach. Pediatr Blood Cancer. 2011; 58(6):953-8. DOI: 10.1002/pbc.23275. View

Dubey A, Sung W, Shaya M, Patwardhan R, Willis B, Smith D . Complications of posterior cranial fossa surgery--an institutional experience of 500 patients. Surg Neurol. 2009; 72(4):369-75. DOI: 10.1016/j.surneu.2009.04.001. View

Gallagher R, Kirkham J, Mason J, Bird K, Williamson P, Nunn A . Development and inter-rater reliability of the Liverpool adverse drug reaction causality assessment tool. PLoS One. 2011; 6(12):e28096. PMC: 3237416. DOI: 10.1371/journal.pone.0028096. View

Mei C, Morgan A . Incidence of mutism, dysarthria and dysphagia associated with childhood posterior fossa tumour. Childs Nerv Syst. 2011; 27(7):1129-36. DOI: 10.1007/s00381-011-1433-x. View

Robertson P, Muraszko K, Holmes E, Sposto R, Packer R, Gajjar A . Incidence and severity of postoperative cerebellar mutism syndrome in children with medulloblastoma: a prospective study by the Children's Oncology Group. J Neurosurg. 2006; 105(6 Suppl):444-51. DOI: 10.3171/ped.2006.105.6.444. View

Drachman D, Diamond E, Hart C . Posturally-evoked vomiting; Association with posterior fossa lesions. Ann Otol Rhinol Laryngol. 1977; 86(1 Pt 1):97-101. DOI: 10.1177/000348947708600117. View

10.

Pomposelli J, Gupta S, Zacharoulis D, Landa R, Miller A, Nanda R . Surgical complication outcome (SCOUT) score: a new method to evaluate quality of care in vascular surgery. J Vasc Surg. 1997; 25(6):1007-14; discussion 1014-5. DOI: 10.1016/s0741-5214(97)70124-1. View

11.

Kao G, Goldwein J, Schultz D, Radcliffe J, Sutton L, Lange B . The impact of perioperative factors on subsequent intelligence quotient deficits in children treated for medulloblastoma/posterior fossa primitive neuroectodermal tumors. Cancer. 1994; 74(3):965-71. DOI: 10.1002/1097-0142(19940801)74:3<965::aid-cncr2820740328>3.0.co;2-z. View

12.

Sonderkaer S, Schmiegelow M, Carstensen H, Nielsen L, Muller J, Schmiegelow K . Long-term neurological outcome of childhood brain tumors treated by surgery only. J Clin Oncol. 2003; 21(7):1347-51. DOI: 10.1200/JCO.2003.08.009. View

13.

Clavien P, Sanabria J, Strasberg S . Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery. 1992; 111(5):518-26. View

14.

Catsman-Berrevoets C, van Dongen H, Mulder P, Paz Y Geuze D, Paquier P, Lequin M . Tumour type and size are high risk factors for the syndrome of "cerebellar" mutism and subsequent dysarthria. J Neurol Neurosurg Psychiatry. 1999; 67(6):755-7. PMC: 1736675. DOI: 10.1136/jnnp.67.6.755. View

15.

Korah M, Esiashvili N, Mazewski C, Hudgins R, Tighiouart M, Janss A . Incidence, risks, and sequelae of posterior fossa syndrome in pediatric medulloblastoma. Int J Radiat Oncol Biol Phys. 2009; 77(1):106-12. DOI: 10.1016/j.ijrobp.2009.04.058. View

16.

Roncadin C, Dennis M, Greenberg M, Spiegler B . Adverse medical events associated with childhood cerebellar astrocytomas and medulloblastomas: natural history and relation to very long-term neurobehavioral outcome. Childs Nerv Syst. 2008; 24(9):995-1002. DOI: 10.1007/s00381-008-0658-9. View

17.

BRUCE J, Russell E, Mollison J, Krukowski Z . The measurement and monitoring of surgical adverse events. Health Technol Assess. 2001; 5(22):1-194. DOI: 10.3310/hta5220. View

18.

Buzunov E, Ojemann J, Robinson F . Rhesus macaque as an animal model for posterior fossa syndrome following tumor resection. Pediatr Neurosurg. 2010; 46(2):120-6. PMC: 2939991. DOI: 10.1159/000319008. View

19.

Mitropoulos D, Artibani W, Graefen M, Remzi M, Roupret M, Truss M . Reporting and grading of complications after urologic surgical procedures: an ad hoc EAU guidelines panel assessment and recommendations. Eur Urol. 2011; 61(2):341-9. DOI: 10.1016/j.eururo.2011.10.033. View

20.

Puget S, Boddaert N, Viguier D, Kieffer V, Bulteau C, Garnett M . Injuries to inferior vermis and dentate nuclei predict poor neurological and neuropsychological outcome in children with malignant posterior fossa tumors. Cancer. 2009; 115(6):1338-47. DOI: 10.1002/cncr.24150. View