{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:09:30Z","timestamp":1767704970609,"version":"3.48.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurooncol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Craniotomy for tumor resection in the pediatric population can result in many potential postoperative events (POEs). POEs, in turn, are a function of many variables, such as tumor type, size, location, surgeon experience and goal(s) of surgery. The current literature is limited to either specific POEs or complications associated with specific tumor pathologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The primary purpose of this study was to undertake a holistic approach and identify those variables predictive of all types of POEs and only surgical ones, following elective craniotomy for tumor in a diverse pediatric population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      All elective craniotomies for tumor resection performed from 2010 to 2022 were included, excluding patients\u2009&gt;\u200921 years of age. Demographic, clinical, and procedural covariates for each encounter (i.e., operation) were collected. POE was defined as a postoperative incident (medical or surgical, expected or unexpected) that necessitated further diagnostic testing, evaluation, or intervention within 90 days of surgery. Bivariate and multivariate analysis were performed; backward model selection was done to yield a final multivariate model retaining only variables with\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1,276 patients underwent 1,497 elective craniotomies for tumor resection with a median age of 9.45 years at index operation. In 535 (36%) encounters, there was at least one POE: 329 (61%) had surgical only, 109 (20%) had medical only, and 97 (18%) had both surgical and medical POEs. Multivariate analysis found several predictors of all types of POEs: length of stay (LOS)\u2009&gt;\u20097 days, length of ICU stay (ICUS), attending surgeon, surgical time, and prior craniotomy. All of these, in addition to previously treated hydrocephalus and tumor type, were predictors of surgical-only POEs. All identified covariates were promoters of POE except for tumor type and redo craniotomy, which were protective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Analysis of our large pediatric tumor database identified several key statistical drivers of all POEs and surgical-only POEs following elective tumor resection, of which LOS\u2009&gt;\u20097 days was the strongest.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11060-025-05239-y","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T07:38:20Z","timestamp":1760945900000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post-operative events following elective craniotomy for tumor in children"],"prefix":"10.1007","volume":"176","author":[{"given":"C. Stewart","family":"Nichols","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emal","family":"Lesha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delaney","family":"Graham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David G.","family":"Laird","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandy","family":"Vaughn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nir","family":"Shimony","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Klimo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,20]]},"reference":[{"issue":"Supplement5","key":"5239_CR1","doi-asserted-by":"publisher","first-page":"v1","DOI":"10.1093\/neuonc\/noz150","volume":"21","author":"QT Ostrom","year":"2019","unstructured":"Ostrom QT, Cioffi G, Gittleman H et al (2019) CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the united States in 2012\u20132016. Neuro-Oncol 21(Supplement5):v1\u2013v100. https:\/\/doi.org\/10.1093\/neuonc\/noz150","journal-title":"Neuro-Oncol"},{"key":"5239_CR2","doi-asserted-by":"crossref","unstructured":"Albright AL, Pollack IF, Adelson PD, Solot JJ (1999) Outcome data and analysis in pediatric neurosurgery. Neurosurgery. 1:101","DOI":"10.1227\/00006123-199907000-00025"},{"issue":"11","key":"5239_CR3","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1007\/s00381-010-1086-1","volume":"26","author":"FW Neervoort","year":"2010","unstructured":"Neervoort FW, Van Ouwerkerk WJR, Folkersma H, Kaspers GJL, Vandertop WP (2010) Surgical morbidity and mortality of pediatric brain tumors: a single center audit. Childs Nerv Syst 26(11):1583\u20131592. https:\/\/doi.org\/10.1007\/s00381-010-1086-1","journal-title":"Childs Nerv Syst"},{"issue":"5","key":"5239_CR4","doi-asserted-by":"publisher","first-page":"556","DOI":"10.3171\/2020.9.PEDS20556","volume":"27","author":"MT Foster","year":"2021","unstructured":"Foster MT, Hennigan D, Grayston R et al (2021) Reporting morbidity associated with pediatric brain tumor surgery: are the available scoring systems sufficient? J Neurosurg Pediatr 27(5):556\u2013565. https:\/\/doi.org\/10.3171\/2020.9.PEDS20556","journal-title":"J Neurosurg Pediatr"},{"issue":"3","key":"5239_CR5","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1007\/s00381-017-3358-5","volume":"33","author":"E Campbell","year":"2017","unstructured":"Campbell E, Beez T, Todd L (2017) Prospective review of 30-day morbidity and mortality in a paediatric neurosurgical unit. Childs Nerv Syst 33(3):483\u2013489. https:\/\/doi.org\/10.1007\/s00381-017-3358-5","journal-title":"Childs Nerv Syst"},{"issue":"5","key":"5239_CR6","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1007\/s00381-012-2006-3","volume":"29","author":"M Von Lehe","year":"2013","unstructured":"Von Lehe M, Kim HJ, Schramm J, Simon M (2013) A comprehensive analysis of early outcomes and complication rates after 769 craniotomies in pediatric patients. Childs Nerv Syst 29(5):781\u2013790. https:\/\/doi.org\/10.1007\/s00381-012-2006-3","journal-title":"Childs Nerv Syst"},{"issue":"6","key":"5239_CR7","doi-asserted-by":"publisher","first-page":"544","DOI":"10.3171\/2010.1.PEDS09305","volume":"5","author":"JM Drake","year":"2010","unstructured":"Drake JM, Riva-Cambrin J, Jea A, Auguste K, Tamber M, Lamberti-Pasculli M (2010) Prospective surveillance of complications in a pediatric neurosurgery unit: clinical Article. J Neurosurg Pediatr 5(6):544\u2013548. https:\/\/doi.org\/10.3171\/2010.1.PEDS09305","journal-title":"J Neurosurg Pediatr"},{"issue":"1","key":"5239_CR8","doi-asserted-by":"publisher","first-page":"107","DOI":"10.3171\/2013.9.PEDS13222","volume":"13","author":"EJ Van Lindert","year":"2014","unstructured":"Van Lindert EJ, Delye H, Leonardo J (2014) Prospective review of a single center\u2019s general pediatric neurosurgical intraoperative and postoperative complication rates: clinical Article. J Neurosurg Pediatr 13(1):107\u2013113. https:\/\/doi.org\/10.3171\/2013.9.PEDS13222","journal-title":"J Neurosurg Pediatr"},{"issue":"5","key":"5239_CR9","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1159\/000501042","volume":"54","author":"S Ajmera","year":"2019","unstructured":"Ajmera S, Motiwala M, Lingo R et al (2019) Emergent and urgent craniotomies in pediatric patients: resource utilization and cost analysis. Pediatr Neurosurg 54(5):301\u2013309. https:\/\/doi.org\/10.1159\/000501042","journal-title":"Pediatr Neurosurg"},{"issue":"8","key":"5239_CR10","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1007\/s00381-013-2171-z","volume":"29","author":"P Steinbok","year":"2013","unstructured":"Steinbok P, Mangat JS, Kerr JM et al (2013) Neurological morbidity of surgical resection of pediatric cerebellar Astrocytomas. Childs Nerv Syst 29(8):1269\u20131275. https:\/\/doi.org\/10.1007\/s00381-013-2171-z","journal-title":"Childs Nerv Syst"},{"key":"5239_CR11","doi-asserted-by":"publisher","first-page":"1241145","DOI":"10.3389\/fendo.2023.1241145","volume":"14","author":"Y Miao","year":"2023","unstructured":"Miao Y, Fan K, Peng X et al (2023) Postoperative hypothalamic-pituitary dysfunction and long-term hormone replacement in patients with childhood-onset craniopharyngioma. Front Endocrinol 14:1241145. https:\/\/doi.org\/10.3389\/fendo.2023.1241145","journal-title":"Front Endocrinol"},{"issue":"1","key":"5239_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/2013.8.PEDS12546","volume":"13","author":"J Goodden","year":"2014","unstructured":"Goodden J, Pizer B, Pettorini B et al (2014) The role of surgery in optic pathway\/hypothalamic gliomas in children: clinical Article. J Neurosurg Pediatr 13(1):1\u201312. https:\/\/doi.org\/10.3171\/2013.8.PEDS12546","journal-title":"J Neurosurg Pediatr"},{"issue":"4","key":"5239_CR13","doi-asserted-by":"publisher","first-page":"367","DOI":"10.3171\/2023.11.PEDS23364","volume":"33","author":"AK Malhotra","year":"2024","unstructured":"Malhotra AK, Nobre L, Ibrahim GM et al (2024) Complications following resection of primary and recurrent pediatric posterior fossa ependymoma. J Neurosurg Pediatr 33(4):367\u2013373. https:\/\/doi.org\/10.3171\/2023.11.PEDS23364","journal-title":"J Neurosurg Pediatr"},{"issue":"5","key":"5239_CR14","doi-asserted-by":"publisher","first-page":"524","DOI":"10.3171\/2012.1.PEDS11465","volume":"9","author":"C Williams","year":"2012","unstructured":"Williams C, Simon TD, Riva-Cambrin J, Bratton SL (2012) Hyponatremia with intracranial malignant tumor resection in children: clinical Article. J Neurosurg Pediatr 9(5):524\u2013529. https:\/\/doi.org\/10.3171\/2012.1.PEDS11465","journal-title":"J Neurosurg Pediatr"},{"issue":"3","key":"5239_CR15","doi-asserted-by":"publisher","first-page":"343","DOI":"10.3171\/2023.3.PEDS22373","volume":"32","author":"R Bokhari","year":"2023","unstructured":"Bokhari R, Elkaim LM, Shlobin NA et al (2023) Vasospasm following brain tumor resection in children: institutional experience and systematic review. J Neurosurg Pediatr 32(3):343\u2013350. https:\/\/doi.org\/10.3171\/2023.3.PEDS22373","journal-title":"J Neurosurg Pediatr"},{"key":"5239_CR16","doi-asserted-by":"publisher","first-page":"117100","DOI":"10.1016\/j.jns.2020.117100","volume":"418","author":"M Chihi","year":"2020","unstructured":"Chihi M, Gembruch O, Ahmadipour Y et al (2020) Predictors of catheter-associated meningitis in pediatric patients after brain tumor surgery: A 10-year single center experience. J Neurol Sci 418:117100. https:\/\/doi.org\/10.1016\/j.jns.2020.117100","journal-title":"J Neurol Sci"},{"issue":"3","key":"5239_CR17","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1007\/s11060-024-04887-w","volume":"171","author":"E Lesha","year":"2025","unstructured":"Lesha E, Roach JT, Miller LE et al (2025) Length of stay following elective craniotomy for tumor resection in children and young adults: a retrospective case series. J Neurooncol 171(3):651\u2013658. https:\/\/doi.org\/10.1007\/s11060-024-04887-w","journal-title":"J Neurooncol"},{"issue":"3","key":"5239_CR18","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1007\/s11060-025-05021-0","volume":"173","author":"E Lesha","year":"2025","unstructured":"Lesha E, Laird DG, Nichols CS et al (2025) Variables associated with 90-day readmission following craniotomy for tumor in the pediatric population. J Neurooncol 173(3):759\u2013767. https:\/\/doi.org\/10.1007\/s11060-025-05021-0","journal-title":"J Neurooncol"},{"issue":"1","key":"5239_CR19","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1097\/ANA.0000000000000871","volume":"36","author":"AI Drapeau","year":"2024","unstructured":"Drapeau AI, Mpody C, Gross MA, Lemus R, Tobias JD, Nafiu O (2024) Factors associated with unplanned Post-Craniotomy Re-intubation in children: A NSQIP-Pediatric\u00ae analysis. J Neurosurg Anesthesiol 36(1):37\u201344. https:\/\/doi.org\/10.1097\/ANA.0000000000000871","journal-title":"J Neurosurg Anesthesiol"},{"key":"5239_CR20","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.jss.2022.02.045","volume":"276","author":"NJ Iglesias","year":"2022","unstructured":"Iglesias NJ, Arrowood R, Montgomery L, Leeper E, Tsao KJ, Iglesias JL (2022) Operative time is independently associated with morbidity in pediatric complicated appendicitis. J Surg Res 276:143\u2013150. https:\/\/doi.org\/10.1016\/j.jss.2022.02.045","journal-title":"J Surg Res"},{"issue":"10","key":"5239_CR21","doi-asserted-by":"publisher","first-page":"3049","DOI":"10.1007\/s00381-021-05256-y","volume":"37","author":"A S\u00e1enz","year":"2021","unstructured":"S\u00e1enz A, Badaloni E, Grijalba M, Villalonga JF, Arga\u00f1araz R, Mantese B (2021) Risk factors for surgical site infection in pediatric posterior fossa tumors. Childs Nerv Syst 37(10):3049\u20133056. https:\/\/doi.org\/10.1007\/s00381-021-05256-y","journal-title":"Childs Nerv Syst"},{"key":"5239_CR22","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.wneu.2016.03.087","volume":"91","author":"J Anthofer","year":"2016","unstructured":"Anthofer J, Wester M, Zeman F, Brawanski A, Schebesch KM (2016) Case-Control study of patients at risk of medical complications after elective craniotomy. World Neurosurg 91:58\u201365. https:\/\/doi.org\/10.1016\/j.wneu.2016.03.087","journal-title":"World Neurosurg"},{"key":"5239_CR23","doi-asserted-by":"publisher","first-page":"e1505","DOI":"10.1016\/j.wneu.2018.11.091","volume":"122","author":"A Nunno","year":"2019","unstructured":"Nunno A, Li Y, Pieters TA et al (2019) Risk factors and associated complications of symptomatic venous thromboembolism in patients with craniotomy for meningioma. World Neurosurg 122:e1505\u2013e1510. https:\/\/doi.org\/10.1016\/j.wneu.2018.11.091","journal-title":"World Neurosurg"},{"issue":"6","key":"5239_CR24","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.3171\/jns.2003.98.6.1175","volume":"98","author":"SM Chang","year":"2003","unstructured":"Chang SM, Parney IF, Mcdermott M et al (2003) Perioperative complications and neurological outcomes of first and second craniotomies among patients enrolled in the glioma outcome project. J Neurosurg 98(6):1175\u20131181. https:\/\/doi.org\/10.3171\/jns.2003.98.6.1175","journal-title":"J Neurosurg"},{"issue":"4","key":"5239_CR25","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1227\/NEU.0b013e31823bcc61","volume":"70","author":"B Lassen","year":"2012","unstructured":"Lassen B, Helseth E, Egge A, Due-T\u00f8nnessen BJ, R\u00f8nning P, Meling TR (2012) Surgical mortality and selected complications in 273 consecutive craniotomies for intracranial tumors in pediatric patients. Neurosurgery 70(4):936\u2013943. https:\/\/doi.org\/10.1227\/NEU.0b013e31823bcc61","journal-title":"Neurosurgery"},{"issue":"1","key":"5239_CR26","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1007\/s10143-021-01570-w","volume":"45","author":"P Tabakow","year":"2022","unstructured":"Tabakow P, Weiser A, Burzynska M, Blauciak P (2022) Endoscopic third ventriculostomy before surgery of third ventricle and posterior fossa tumours decreases the risk of secondary hydrocephalus and early postoperative complications. Neurosurg Rev 45(1):771\u2013781. https:\/\/doi.org\/10.1007\/s10143-021-01570-w","journal-title":"Neurosurg Rev"},{"key":"5239_CR27","unstructured":"Ortiz Torres M, Shafiq I, Mesfin FB (2025) Pediatric craniopharyngioma. StatPearls [Internet]. StatPearls Publishing. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK519027\/"},{"issue":"1","key":"5239_CR28","doi-asserted-by":"publisher","first-page":"3","DOI":"10.3171\/ped.2007.106.1.3","volume":"106","author":"S Puget","year":"2007","unstructured":"Puget S, Garnett M, Wray A et al (2007) Pediatric craniopharyngiomas: classification and treatment according to the degree of hypothalamic involvement. J Neurosurg Pediatr 106(1):3\u201312. https:\/\/doi.org\/10.3171\/ped.2007.106.1.3","journal-title":"J Neurosurg Pediatr"},{"issue":"3","key":"5239_CR29","doi-asserted-by":"publisher","first-page":"627","DOI":"10.3171\/2015.3.JNS142254","volume":"124","author":"S Jeswani","year":"2016","unstructured":"Jeswani S, Nu\u00f1o M, Wu A et al (2016) Comparative analysis of outcomes following craniotomy and expanded endoscopic endonasal transsphenoidal resection of craniopharyngioma and related tumors: a single-institution study. J Neurosurg 124(3):627\u2013638. https:\/\/doi.org\/10.3171\/2015.3.JNS142254","journal-title":"J Neurosurg"}],"container-title":["Journal of Neuro-Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11060-025-05239-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11060-025-05239-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11060-025-05239-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T12:34:57Z","timestamp":1767702897000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11060-025-05239-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,20]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["5239"],"URL":"https:\/\/doi.org\/10.1007\/s11060-025-05239-y","relation":{},"ISSN":["0167-594X","1573-7373"],"issn-type":[{"type":"print","value":"0167-594X"},{"type":"electronic","value":"1573-7373"}],"subject":[],"published":{"date-parts":[[2025,10,20]]},"assertion":[{"value":"5 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"28"}}