gms | German Medical Science

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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Trauma of the really old: 30-day mortality of patients older than 90 years old

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  • Ehab Shiban - Klinikum rechts der Isar TU München , München, Deutschland
  • Rothlauf Paulina - 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.09.07

doi: 10.3205/17dgnc234, urn:nbn:de:0183-17dgnc2342

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: Aim was to identify variables that may predict early mortality in geriatric trauma patients over the age of 90.

Methods: A retrospective analysis of all patients over the age of 90, that were treated between 2006 and 2014 at out department was performed. Patient characteristics, type of injury and comorbidities were analyzed with regards to the 30-day mortality rate.

Results: 113 patients were identified. Mean age 93 (range 91-102), 60 (53.1%) patients were female. 83 (73.5%) and 30 (26.5%) of patients presented with head and spinal trauma, respectively. 75 (66.4%) patients were on anticoagulation therapy. 53 (46.9%) patients were treated operatively. Mean Hospital stay was 10 days (range 1-31). Mean charlson comorbidity index was 4.6 (range 0-16) and mean diagnosis count was 10.5 (range2-23). The 30-day mortality rate was 25.7% and was significantly affected by the diagnosis (p=0.001). The highest mortality rate was seen in patients with acute subdural hematoma (50% surgery group surgery, 33% conservative group), followed by patients with cervical spine fractures (40% surgery group, 37.5% conservative group). Gender (p=0.37), diagnosis count (p=0.97), charlson index (p=0.76) and anticoagulation therapy (p=0.936) did not correlate with the 30-day mortality rate.

Conclusion: 30-day mortality rate in patients over 90-year-old following head or spine trauma or is very high regardless of the treatment modality. Standard geriatric prognostic scores seem less reliable for those patients..