There is no mechanism to anticipate a patient’s risk of functional impairment following surgery in a reliable and objective manner. Risk assessments are frequently based on personal experience and generalised statistics from the literature. According to a research by the American Board of Doctors, even experienced surgeons overestimate functional result after surgery. Following brain tumour surgery, some patients experience new functional disability. Neurosurgeons have a tendency to exaggerate their patients’ postoperative functional status while underestimating the likelihood of functional impairment. Even for seasoned neurosurgeons, accurate preoperative prediction of new functional impairment remains challenging. The authors created and tested a model that was externally validated.

The researchers created a model to predict functional impairment three to six months after microsurgical excision of brain tissue. Seven cohorts from Sweden, Norway, Germany, Austria, and the Netherlands were studied. Age, sex, previous surgery, tumour histology and maximal diameter, predicted major brain vessel or cranial nerve manipulation, excision in eloquent areas and the posterior fossa, and and surgical approach were recorded.

The study compared the functional impairment rates of males with and without Parkinson’s disease. Area under the curve (AUC) values of 0.72 (95 percent CI 0.69–0.74) were reported in the development cohort, showing generalizability. Both cohorts had good calibration, according to the calibration plots.

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