Clinical and Epidemiological Characteristics of Adult Patients With Primary Brain Tumors in Guatemala: A Retrospective Study

Introduction: Brain tumors cause high morbidity and mortality and decrease patients' quality of life and autonomy. While their clinical and epidemiological characteristics have been described worldwide, data are scarce in resource-limited areas, where diagnosis and treatment are often difficult. Purpose: This study aimed to characterize the clinical and epidemiological profile of patients with primary brain tumors aged 20-65 years admitted to the Neurosurgery Department of the Regional Hospital of the West (Guatemala) between January 2018 and January 2022, and, as exploratory secondary aims, to assess the associations between sex and tumor classification, World Health Organization grade and postoperative complications, and tumor classification and postoperative functional autonomy. Methods: A retrospective, single-center observational study was conducted with descriptive analyses and exploratory inferential testing. The full cohort (n = 28) was analyzed for epidemiological and clinical variables; analyses of discharge status and postoperative functional autonomy (Karnofsky Performance Status (KPS)) were restricted to 23 patients, after excluding five who left against medical advice before hospital discharge. KPS was retrospectively documented at discharge from clinical descriptors in the medical record. Categorical variables are presented as frequencies, n (%), and continuous variables as mean ± standard deviation or median (interquartile range). Missing data were handled case-wise. Analyses were performed using Microsoft Excel 2024 (Microsoft Corporation, Redmond, WA) and Python 3.11 with SciPy (Python Software Foundation, Fredericksburg, VA; Fisher's exact and Mann-Whitney U tests; p < 0.05). Results: It was found that 57.2% (n = 16) of tumors occurred in patients aged 51-65 years, 53.6% (n = 15) were female, 46.4% (n = 13) were from Quetzaltenango, and 71.4% (n = 20) were Ladino/Mestizo. Meningiomas accounted for 46.4% (n = 13); mortality was 26.1% (n = 6). Exploratory analyses showed nonsignificant trends: higher malignancy in men (risk ratio (RR) = 1.54, 95% confidence interval (CI) = 0.42-5.64; p = 0.670), more postoperative complications with high-grade tumors (RR = 1.68, 95% CI = 0.62-4.58; p = 0.603), and lower postoperative KPS in malignant vs. benign tumors (median 30 vs. 70; Mann-Whitney U = 60.5; p = 0.256). Conclusion: Primary brain tumors in this cohort were more frequent in female patients, with meningiomas as the most common histopathology and most patients residing in the hospital's department. Unlike studies typically reporting median ages above 70 years, patients here were younger (51-65 years) with a higher mortality rate. Exploratory analyses showed nonsignificant trends consistent with the international literature; given the descriptive, retrospective, single-center design and small sample size, these findings should be interpreted as hypothesis-generating only and do not support causal inference. No prior Guatemalan study reported prevalence by ethnic group, establishing a precedent for future research.