Outcome and Complications in Surgical Treatment of Lumbar Stenosis or Spondylolisthesis in Geriatric Patients

Introduction: The surgical treatment of proximal femoral fractures predominantly involves geriatric patients and is associated with high morbidity and mortality. However, analyses on postoperative infections or hematoma are rare. Methods: Patients requiring surgical revision due to infection (n = 90) or hematoma (n = 77) in the postoperative phase were identified from an electronic database of 2000 consecutive patients surgically treated for proximal femoral fractures between 2006 and 2014. Demographic and clinical data were retrieved, including information on the pathogens in patients with infection. A follow-up on morbidity and mortality was conducted via telephone for at least 2 years postsurgery. Results: The follow-up rate was 100%, and the mean age was 81.9 years. The incidence rate of infection was 4.1% (90/2000), and women were commonly affected. Staphylococcus aureus and Staphylococcus epidermidis were the most commonly detected pathogens (35.5% and 25.5%, respectively). Mixed infections were observed in 15 patients, and Methicillin-resistant Staphylococcus aureus infections were observed in only 4 patients. A total of 77 (85.6%) infections occurred within 30 days postsurgery. The implant was preserved in 76 (84.4%) patients, and resection arthroplasty was required in 14 patients. Dementia and pertrochanteric fractures were significantly more common in the infection than in the hematoma group. Although infections were associated with high mortality rates for up to 2 years postsurgery, the rates did not significantly differ from those in the hematoma control group. Conclusion: One of every 2 patients who developed an infection following the surgical treatment of a proximal femoral fracture died within 2 years postsurgery. In addition, infections were significantly associated with dementia. Avoiding postoperative infection should be a high priority in the surgical treatment of proximal femoral fractures.

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Complications from the surgical treatment of lumbar stenosis

Seminars in Spine Surgery ◽

10.1053/j.semss.2019.04.005 ◽

2019 ◽

Vol 31 (3) ◽

pp. 100711

Author(s):

Ananth S. Eleswarapu

Keyword(s):

Surgical Treatment ◽

Lumbar Stenosis

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Surgical Treatment Effect Durable at 4 Years for Lumbar Stenosis

Neurosurgery ◽

10.1227/01.neu.0000389734.11364.dc ◽

2010 ◽

Vol 67 (4) ◽

pp. N18-N19

Author(s):

John H Chi

Keyword(s):

Surgical Treatment ◽

Treatment Effect ◽

Lumbar Stenosis

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Cost-effectiveness of conservative versus surgical treatment strategies of lumbar spinal stenosis in the Swiss setting: analysis of the prospective multicenter Lumbar Stenosis Outcome Study (LSOS)

European Spine Journal ◽

10.1007/s00586-016-4937-y ◽

2016 ◽

Vol 26 (2) ◽

pp. 501-509 ◽

Cited By ~ 11

Author(s):

A. Aichmair ◽

◽

J. M. Burgstaller ◽

M. Schwenkglenks ◽

J. Steurer ◽

...

Keyword(s):

Cost Effectiveness ◽

Surgical Treatment ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Treatment Strategies ◽

Outcome Study ◽

Lumbar Stenosis ◽

Lumbar Spinal

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ACKT: A Proposal for a Novel Score to Predict Prolonged Mechanical Ventilation after Surgical Treatment of Meningioma in Geriatric Patients

Cancers ◽

10.3390/cancers13010098 ◽

2020 ◽

Vol 13 (1) ◽

pp. 98

Author(s):

Elisa Scharnböck ◽

Leonie Weinhold ◽

Anna-Laura Potthoff ◽

Niklas Schäfer ◽

Muriel Heimann ◽

...

Keyword(s):

Mechanical Ventilation ◽

Surgical Treatment ◽

Geriatric Patients ◽

Prolonged Mechanical Ventilation ◽

Individual Risk ◽

Clinical Aspects ◽

Karnofsky Performance Scale ◽

Intracranial Meningioma ◽

Patient Counseling ◽

The Impact

Indication for surgical treatment in patients with intracranial meningioma must include both clinical aspects and an individual risk–benefit stratification, especially in geriatric patients. Prolonged mechanical ventilation (PMV) has not been investigated for its potential effects in patients with meningioma. We therefore analyzed the impact of PMV on mortality in geriatric patients who had undergone meningioma resection. Between 2009 and 2019, 261 patients aged ≥ 70 years were surgically treated for intracranial meningioma at our institution. PMV was defined as postoperative invasive ventilation of >7 days. Postoperative PMV was present in 17 of 261 geriatric meningioma patients (7%). Twenty-five geriatric patients (10%) died within 1 year after surgery. A scoring system (“ACKT”) based on the variables of age, preoperative C-reactive protein (CRP) value, Karnofsky performance scale and tumor size supports prediction of postoperative PMV (sensitivity 73%, specificity 84%). PMV is significantly associated with increased mortality after surgical treatment of meningiomas in geriatric patients. Furthermore, we suggest a novel score (“ACKT”) to preoperatively estimate the risk of PMV occurrence, which might help to guide future risk–benefit assessment and patient counseling in the geriatric meningioma population.

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