caa a22 4500 445329351 CHVBK 20180317142732.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s10143-010-0301-6 doi (NATIONALLICENCE)springer-10.1007/s10143-010-0301-6 Neurosurgery and elderly: analysis through the years [Elektronische Daten] [Salvatore Chibbaro, F. Di Rocco, O. Makiese, G. Mirone, M. Marsella, A. Lukaszewicz, E. Vicaut, B. Turner, S. Hamdi, T. Spiriev, P. Di Emidio, R. Pirracchio, D. Payen, B. George, D. Bresson] 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 70years 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 25years. The number of procedures on patients over 70years 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. Springer-Verlag, 2011 Geriatric neurosurgery nationallicence Craniotomy nationallicence Brain surgery nationallicence Spine surgery nationallicence Elderly nationallicence Chibbaro Salvatore Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut Di Rocco F. Neurosurgery Department, Necker University Hospital Paris, Paris, France aut Makiese O. Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut Mirone G. Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut Marsella M. Tucson Centre for Neuroscience, Tucson, AZ, USA aut Lukaszewicz A. Neuro-ICU/Anaesthesia Department Lariboisiere, University Hospital Paris, Paris, France aut Vicaut E. Unité de Recherche Clinique Hôpital Universitaire Lariboisière - Fernand Widal, Paris, France aut Turner B. Neurology Department Royal London Hospital, London, UK aut Hamdi S. Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut Spiriev T. Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut Di Emidio P. Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut Pirracchio R. Neuro-ICU/Anaesthesia Department Lariboisiere, University Hospital Paris, Paris, France aut Payen D. Neuro-ICU/Anaesthesia Department Lariboisiere, University Hospital Paris, Paris, France aut George B. Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut Bresson D. Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut Neurosurgical Review Springer-Verlag 34/2(2011-04-01), 229-234 0344-5607 34:2<229 2011 34 10143 https://doi.org/10.1007/s10143-010-0301-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10143-010-0301-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Chibbaro Salvatore Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut NATIONALLICENCE 700 1- Di Rocco F. Neurosurgery Department, Necker University Hospital Paris, Paris, France aut NATIONALLICENCE 700 1- Makiese O. Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut NATIONALLICENCE 700 1- Mirone G. Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut NATIONALLICENCE 700 1- Marsella M. Tucson Centre for Neuroscience, Tucson, AZ, USA aut NATIONALLICENCE 700 1- Lukaszewicz A. Neuro-ICU/Anaesthesia Department Lariboisiere, University Hospital Paris, Paris, France aut NATIONALLICENCE 700 1- Vicaut E. Unité de Recherche Clinique Hôpital Universitaire Lariboisière - Fernand Widal, Paris, France aut NATIONALLICENCE 700 1- Turner B. Neurology Department Royal London Hospital, London, UK aut NATIONALLICENCE 700 1- Hamdi S. Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut NATIONALLICENCE 700 1- Spiriev T. Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut NATIONALLICENCE 700 1- Di Emidio P. Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut NATIONALLICENCE 700 1- Pirracchio R. Neuro-ICU/Anaesthesia Department Lariboisiere, University Hospital Paris, Paris, France aut NATIONALLICENCE 700 1- Payen D. Neuro-ICU/Anaesthesia Department Lariboisiere, University Hospital Paris, Paris, France aut NATIONALLICENCE 700 1- George B. Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut NATIONALLICENCE 700 1- Bresson D. Neurosurgery Department, Lariboisiere University Hospital, Paris, France aut NATIONALLICENCE 773 0- Neurosurgical Review Springer-Verlag 34/2(2011-04-01), 229-234 0344-5607 34:2<229 2011 34 10143 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer