The epidemiology of patients undergoing meningioma resection in Auckland, New Zealand, 2002 to 2011

E kaua e hoki i te waewae tūtuki, ā, apā anō hei te ūpoko pakaru - a systematic review of neurosurgical disease and care for Māori in New Zealand

BACKGROUND

The Royal Australasian College of Surgeons (RACS) Te Rautaki Māori cites the need for more research dedicated to health equity in surgery for Māori. However, the gaps in research for Māori in surgery have not yet been highlighted. This review is the first in a series of reviews named Te Ara Pokanga that seeks to identify these gaps over all nine surgical specialties. The aim of this study was to assess neurosurgical disease incidence and perioperative outcomes for Māori at any point from referral through to the postoperative period.

METHODS

A systematic review of Māori neurosurgical disease and care for Māori in NZ was performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement assisted study selection and reporting. Kaupapa Māori (Māori-centred) research methodology and the Māori Framework were utilized to evaluate Māori research responsiveness.

RESULTS

Nine studies were included in this review. All studies were retrospective cohort studies and only two studies had at least one Māori clinical or academic expert named on their research team. Therefore, only one study was deemed responsive to Māori. Studies assessing long-term outcomes from the management of neurosurgical disease for Māori and patient and whānau experiences of neurosurgical care are lacking.

CONCLUSION

This study indicates the limited scope of research conducted for Māori in neurosurgery. The broader clinical implications of this review highlight the need for good quality research to investigate access to and long-term outcomes from the management of neurosurgical disease for Māori.

The Role of Establishing Neurosurgical Specialist Nurse Working Group in the Recovery and Prevention of Negative Psychological Emotion after Meningioma Surgery

In this research paper, we will explore the role of establishing a neurosurgical specialist nurse working group in the recovery and prevention of negative psychological emotions after meningioma surgery. For this study, 42 meningioma patients who were treated before the establishment of a neurosurgery specialist nurse working group from January 2019 to December 2019. They were selected as the control group. In contrast, 42 meningioma patients admitted after the establishment of the neurosurgery specialist nurse group from January 2020 to December 2020 were selected as the study group. The postoperative recovery (time of stay in the intensive care unit, time of first eating, wakeup time, time of defecation for the first time, and hospitalization time), short-term prognosis, and nursing satisfaction scores of the two groups were calculated, and the post-traumatic stress disorder scale (PTSD-SS), medical coping style questionnaire (MCMQ), and National Institutes of Health Stroke Scale (NIHSS) were compared. Also, the changes in the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) score contributes to the comprehensive analysis of the role of the establishment of neurosurgical specialist nurse working group in the recovery and prevention of negative psychological emotion after meningioma operation. The satisfaction scores in the study group of patients in physical care, receiving information, support, respect, and nursing process were higher than the control group probability (P < 0.05). The first feeding time, defecation time, out of bed, the stay time in the intensive care unit, and the hospitalization time of the study group were shorter than those of the control group (P < 0.05). Before nursing, there was no difference in NIHSS score, SAS score, and SDS scores between the two groups. However, after nursing, the NIHSS score, SAS score, and SDS score of the study group were fairly lower than the control group. Moreover, the Karnofsky functional status scale (KPS) scores of the two groups increased gradually. The KPS scores of the study group at 1 month, 2 months, and 3 months after operation were significantly higher than those of the control group (P < 0.05). Before nursing, there was no significant difference in the scores of post-traumatic stress disorder between the two groups (P > 0.05). After nursing, the scores of subjective evaluation, symptom avoidance, repeated experience, and social dysfunction in the study group were lower than those in the control group (P < 0.05). Before nursing, there was no significant difference in coping scores between the control group and the research group (P > 0.05), but after nursing, the avoidance and compliance scores of the research group were significantly higher than those of the control group (P < 0.05).Similarly, the scores of avoidance and yield in the study group were significantly lower than those in the control group (P < 0.05). In the study group, 1 patient had an incision infection and 1 patient had epilepsy, and the total incidence of postoperative complications was 4.76%. In the control group, 4 patients had incision infection, 1 case of an intracranial hematoma, 3 cases of deep venous thrombosis, and 3 cases of epilepsy. The total incidence of postoperative complications in the study group was 26.19%, while the incidence of postoperative complications in the study group was lower than in the control group (P < 0.05).

Characterization of volumetric growth of intracranial meningiomas in Māori and Pasifika populations in New Zealand

BACKGROUND

Māori and Pasifika populations in New Zealand have a higher incidence and prevalence of intracranial meningioma (IM). We sought to evaluate the volumetric growth rate of meningiomas under surveillance in these populations.

METHODS

From July 2002 to October 2020, 336 patients with a total of 408 IM underwent conservative management with serial radiological surveillance at Auckland City Hospital and met the criteria for the study. Inclusion criteria included: age >16 at diagnosis, ≥2 appropriate scans one or more years apart. Exclusion criteria included previous cranial irradiation, a diagnosis of Neurofibromatosis and prior treatment of meningioma. Demographic and clinical data were obtained from the electronic medical records. Imaging data were recorded from the first and last scans. We utilized open-source image processing software (3D Slicer) for semi-automated segmentation and volume calculation. Consistent with previous literature, we calculated the relative growth rate (RGR, %/year) and annual volume change (AVC, cm3 /year) over time.

RESULTS

Four hundred and eight meningiomas were volumetrically characterized for a mean duration of 6.2 years. The Māori and Pasifika populations (n = 134/393) demonstrated a higher RGR (31.41 versus 14.33%/year) (P = 0.026) and AVC (2.05 versus 0.95 cm3 ) (P = 0.025) compared to the control population. They also presented at a younger age and had a higher rate of tumour multiplicity. Males represented only 17.6% of the cohort but exhibited a higher growth rate (AVC = 2.52 cm3 /year) than females (AVC = 0.99 cm3 /year) (P = 0034).

CONCLUSIONS

Māori and Pasifika populations in New Zealand have a higher incidence and volumetric growth rate of IM compared to a control population. This warrants further clinical, histopathological and genomic analysis.