gms | German Medical Science

Objective: Demographic trends make it incumbent on spine surgeons to recognize the special challenges involved in caring for older patients. Aim of this study was to identify variables that may predict early mortality in geriatric patients over the age of 90.

Methods: Retrospective analyses of all patients over the age of 90-years, which were treated between 2006 and 2014 at out department for degenerative spine disease, were performed. Patient characteristics, type of treatment and comorbidities were analyzed with regards to the 30-day mortality rate.

Results: 25 patients were identified. Mean age was 92.8 years (range 91-101), 21 (84%) patients were female. 16 (64%) patients were on anticoagulation therapy. 17 (68%) patients were treated operatively. Mean Hospital stay was 14 days (range 2-40). Mean charlson comorbidity index was 5.5 (range 0-12) and mean diagnosis count was 12 (range 2-24). The 30-days mortality rate was 17% in the surgically treated group compared to 0% in the conservatively treated group, this difference was however not statistically significant (p=0.2). Gender (p=0.42), diagnosis count (p=0.65), charlson index (p=0.65) and anticoagulation therapy (p=0.9) did not correlate with the 30-day mortality rate. Cause of death was pulmonary embolism in two cases and unknown in one case.

Conclusion: 30-day mortality rate in patients over 90-years-old following elective spine surgery is extremely high. Standard geriatric prognostic scores seem less reliable for these patients. Prospective validations studies are needed in order to establish treatment recommendations for such patients.