SURG-74. Thirty-Day Postoperative Complications Following Intracranial Meningioma Surgery: A Prospective Analysis in a Resource-Limited Setting

Abstract BACKGROUND Meningiomas are the most common primary intracranial tumors, with surgery remaining the definitive treatment. However, surgical intervention carries inherent risks. This prospective study evaluates the 30-day postoperative complications of intracranial meningioma surgery in a resource-limited setting. METHODS A prospective study was conducted at three major teaching hospitals in Addis Ababa between November 1, 2019, and September 1, 2020. Postoperative complications were assessed through standardized questionnaires in both inpatient and outpatient settings. Pathology and intraoperative data were extracted from medical records. Statistical analysis was performed using SPSS. RESULTS A total of 77 patients were included, with a mean age of 40.94 years. Headache was the most common presenting symptom (92%), while 80.5% had focal neurological deficits. Skull base meningiomas accounted for 61% of cases. The one-month surgical mortality rate was 9.1%. Postoperative complications occurred in 48.1% of patients, with new-onset or worsened focal deficits being the most frequent. Skull base tumors were significantly associated with increased postoperative complications (p = 0.01; OR = 5.79; 95% CI: 2.061–16.312). CONCLUSION While postoperative complications and mortality rates remain notable, surgery leads to symptomatic improvement in a large proportion of patients. Skull base meningioma, prolonged anesthesia (>5 hours), and excessive intraoperative blood loss (>1000 mL) are significant predictors of postoperative complications. Optimizing surgical technique and perioperative management is critical in resource-limited environments to improve patient outcomes.