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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Elective spine surgery for patients older than 90-years old: Is 90 the new 80?

Meeting Abstract

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  • Ehab Shiban - Klinikum rechts der Isar TU München , München, Deutschland
  • Bernhard Meyer - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Jens Lehmberg - Klinikum rechts der Isar TU München , München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.08.01

doi: 10.3205/17dgnc223, urn:nbn:de:0183-17dgnc2230

Published: June 9, 2017

© 2017 Shiban et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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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.