Impact of postoperative blood pressure management on postoperative hemorrhage after resection of intraparenchymal brain tumors.

Abstract

This study aimed to assess the relationship between postoperative blood pressure and other common radiological and epidemiological factors in relation to the incidence of postoperative hemorrhage. This retrospective analysis included all patients who underwent surgery between 2016 and 2023 at our institution for an intraparenchymal intracranial tumor. We evaluated blood pressure both intraoperatively and postoperatively for the first 12 postoperative hours. We compared a cohort that experienced postoperative hemorrhage with a cohort that did not require intervention. ROC-analysis were performed to find thresholds for postoperative blood pressure. 453 patients were included. In 35 cases (7.7%), further treatment was necessary due to postoperative hemorrhage. Of these, nine patients required revision surgery, while 26 patients were managed conservatively. Both intra- (p < 0.05) and postoperative (p < 0.001) blood pressure influenced the risk of postoperative hemorrhage significantly. We identified a threshold of 140 mmHg of systolic blood pressure to minimize the risk of postoperative hemorrhage. Maintaining systolic blood pressure below 140 mmHg after surgery seems to be crucial, as patients with postoperative hemorrhage experienced significantly longer durations of elevated systolic pressure (62 min > 140 mmHg and 17 min > 160 mmHg), highlighting its strong influence on hemorrhage risk.