Neurosurgery and elderly: Analysis through the years

Journal article


Chibbaro, Salvatore, Di Rocco, F., Makiese, O., Mirone, G., Marsella, M., Lukaszewicz, A. C., Vicaut, E., Turner, B., Hamdi, S., Spiriev, T., Di Emidio, P., Pirracchio, R., Payen, D., George, B. and Bresson, D.. (2011). Neurosurgery and elderly: Analysis through the years. Neurosurgical Review. 34(2), pp. 229 - 234. https://doi.org/10.1007/s10143-010-0301-6
AuthorsChibbaro, Salvatore, Di Rocco, F., Makiese, O., Mirone, G., Marsella, M., Lukaszewicz, A. C., Vicaut, E., Turner, B., Hamdi, S., Spiriev, T., Di Emidio, P., Pirracchio, R., Payen, D., George, B. and Bresson, D.
Abstract

The aging of the population in westernized countries constitutes an important issue for the health systems struggling with limited resources and increasing costs. Morbidity and mortality rates reported for neurosurgical procedures in the elderly vary widely. The lack of data on risk benefit ratios may result in challenging clinical decisions in this expanding group of patients. The aim of this paper is to analyze the elderly patients cohort undergoing neurosurgical procedures and any trend variations over time. The medical records of elderly patients (defined as an individual of 70 years of age and over) admitted to the Neurosurgical and Neuro-ICU Departments of a major University Hospital in Paris over a 25-year period were retrospectively reviewed. The analysis included: (1) number of admissions, (2) percentage of surgically treated patients, (3) type of procedures performed, (4) length of hospital stay, and (5) mortality. The analysis showed a progressive and significant increase in the proportion of elderly presenting for neurosurgical elective and/or emergency procedures over the last 25 years. The number of procedures on patients over 70 years of age increased significantly whereas the mortality dropped. Though the length of hospital stay was reduced, it remained significantly higher than the average stay. The types of procedures also changed over time with more craniotomies and endovascular procedures being performed. Age should not be considered as a contraindication for complex procedures in neurosurgery. However, downstream structures for postoperative elderly patients must be further developed to reduce the mean hospital stay in neurosurgical departments because this trend is likely to continue to grow.

Keywordsgeriatric neurosurgery; craniotomy; brain surgery; spine surgery; elderly
Year2011
JournalNeurosurgical Review
Journal citation34 (2), pp. 229 - 234
PublisherSpringer-Verlag
ISSN0344-5607
Digital Object Identifier (DOI)https://doi.org/10.1007/s10143-010-0301-6
Scopus EID2-s2.0-79958217695
Page range229 - 234
Research GroupInstitute for Religion, Politics, and Society
Publisher's version
File Access Level
Controlled
Place of publicationGermany
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