OBJECTIVE: The aging population in industrialized countries shifts the age limit for neurosurgical interventions toward increasingly older patients. This study investigates whether octogenarians (≥80 years) stand out in outcome and incidence of perioperative complications. METHODS: Consecutive patients ≥80 years operated on between January 2013 and August 2016 were compared against a control group of patients aged 55-75 years matched by indication for surgery. Status at admission, perioperative complications, functional outcome, and mortality were assessed in a prospective patient registry. Complications were classified in the therapy-oriented Clavien-Dindo grading (CDG) system. RESULTS: We compared 266 octogenarians (median age, 83 years; interquartile range, 81-86 years; 154 men) with 232 controls (median age, 67 years; interquartile range, 60-71 years; 151 men). At follow-up (median, 53 vs. 49 days), median modified Ranking Scale scores were 2 versus 1 and median Karnofsky Performance Status was 80 versus 90; both improved significantly compared to baseline (P < 0.0001). Only admission Karnofsky Performance Status was significantly associated with clinical outcome at follow-up (odds ratio, 1.05; P < 0.0001). Pharmacologic treatment (CDG 2) was sufficient in 56% of all complications in octogenarians (controls, 43%). Octogenarians were more prone to complications as an inpatient (36% vs. 28%; P = 0.04) because of a higher incidence of CDG 2 complications (20% vs. 12%; P = 0.02). The rate of complications that required more extensive therapy did not differ significantly between cohorts. CONCLUSIONS: Neurosurgery in octogenarians had a similar rate of severe complications, morbidity, and mortality as in matched controls. Therefore, age alone should not serve as a contraindication for neurosurgery.
OBJECTIVE: The aging population in industrialized countries shifts the age limit for neurosurgical interventions toward increasingly older patients. This study investigates whether octogenarians (≥80 years) stand out in outcome and incidence of perioperative complications. METHODS: Consecutive patients ≥80 years operated on between January 2013 and August 2016 were compared against a control group of patients aged 55-75 years matched by indication for surgery. Status at admission, perioperative complications, functional outcome, and mortality were assessed in a prospective patient registry. Complications were classified in the therapy-oriented Clavien-Dindo grading (CDG) system. RESULTS: We compared 266 octogenarians (median age, 83 years; interquartile range, 81-86 years; 154 men) with 232 controls (median age, 67 years; interquartile range, 60-71 years; 151 men). At follow-up (median, 53 vs. 49 days), median modified Ranking Scale scores were 2 versus 1 and median Karnofsky Performance Status was 80 versus 90; both improved significantly compared to baseline (P < 0.0001). Only admission Karnofsky Performance Status was significantly associated with clinical outcome at follow-up (odds ratio, 1.05; P < 0.0001). Pharmacologic treatment (CDG 2) was sufficient in 56% of all complications in octogenarians (controls, 43%). Octogenarians were more prone to complications as an inpatient (36% vs. 28%; P = 0.04) because of a higher incidence of CDG 2 complications (20% vs. 12%; P = 0.02). The rate of complications that required more extensive therapy did not differ significantly between cohorts. CONCLUSIONS: Neurosurgery in octogenarians had a similar rate of severe complications, morbidity, and mortality as in matched controls. Therefore, age alone should not serve as a contraindication for neurosurgery.
Authors: Martin N Stienen; David Y Zhang; Morgan Broggi; Dominik Seggewiss; Stefano Villa; Silvia Schiavolin; Oliver Bozinov; Niklaus Krayenbühl; Johannes Sarnthein; Paolo Ferroli; Luca Regli Journal: J Neurooncol Date: 2018-05-02 Impact factor: 4.130
Authors: Yang Yang; Anna M Zeitlberger; Marian C Neidert; Victor E Staartjes; Morgan Broggi; Costanza Maria Zattra; Flavio Vasella; Julia Velz; Jiri Bartek; Alexander Fletcher-Sandersjöö; Petter Förander; Darius Kalasauskas; Mirjam Renovanz; Florian Ringel; Konstantin R Brawanski; Johannes Kerschbaumer; Christian F Freyschlag; Asgeir S Jakola; Kristin Sjåvik; Ole Solheim; Bawarjan Schatlo; Alexandra Sachkova; Hans Christoph Bock; Abdelhalim Hussein; Veit Rohde; Marike L D Broekman; Claudine O Nogarede; Cynthia M C Lemmens; Julius M Kernbach; Georg Neuloh; Niklaus Krayenbühl; Paolo Ferroli; Luca Regli; Oliver Bozinov; Martin N Stienen Journal: Brain Spine Date: 2021-10-21
Authors: Nea Nevalainen; Teemu M Luoto; Grant L Iverson; Ville M Mattila; Tuomas T Huttunen Journal: Acta Neurochir (Wien) Date: 2022-02-04 Impact factor: 2.816