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Surgical Management in Elderly Patients with Tuberculous Spondylodiscitis: Ten Year Mortality Audit Study
STUDY DESIGN: Retrospective study. PURPOSE: To evaluate the factors affecting immediate postoperative mortality in elderly patients with tuberculous spondylodiscitis. OVERVIEW OF LITERATURE: Treatment of spinal tuberculosis in the elderly involves consideration of age and co-morbidities, and often l...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Society of Spine Surgery
2016
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5081327/ https://www.ncbi.nlm.nih.gov/pubmed/27790320 http://dx.doi.org/10.4184/asj.2016.10.5.915 |
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author | Kothari, Manish Kundanmal Shah, Kunal Chandrakant Tikoo, Agnivesh Nene, Abhay Madhusudan |
author_facet | Kothari, Manish Kundanmal Shah, Kunal Chandrakant Tikoo, Agnivesh Nene, Abhay Madhusudan |
author_sort | Kothari, Manish Kundanmal |
collection | PubMed |
description | STUDY DESIGN: Retrospective study. PURPOSE: To evaluate the factors affecting immediate postoperative mortality in elderly patients with tuberculous spondylodiscitis. OVERVIEW OF LITERATURE: Treatment of spinal tuberculosis in the elderly involves consideration of age and co-morbidities, and often leads to an extended conservative management. Surgical intervention in these patients becomes a complex decision. There are no studies on risk factors of mortality in surgically treated elderly with tuberculous spondylodiscitis. METHODS: Two hundred and seventy-six patients with spondylodiscitis were operated between 2005 and 2015. 20 consecutive patients over 70 years of age with and proven tuberculosis who met the inclusion/exclusion criteria were included. Demographic, clinical and radiological profile data with operative details of instrumentation, blood loss, surgical duration, and mortality were noted. There were 20 patients (6 males, 14 females) with a mean age of 73.5 years. The patients were divided into those with mortality (M) and those who survived (non-mortality, NM). Various variables were statistically tested for immediate postoperative medical complications and mortality. RESULTS: There were four mortalities (20%). Age, sex, number of medical co-morbidities, American Society of Anaesthesiologists grade, Frankel grade C or worse, number of vertebrae involved, number of levels fused, blood loss and operative time did not have statistically significant impact on immediate postoperative mortality. Only preoperative immobility duration was statistically higher in the M group (p=0.016) than in the NM group. CONCLUSIONS: Preoperative immobility is associated with immediate postoperative mortality in elderly patients with spinal tuberculosis undergoing surgery. The findings identify preoperative immobility as a risk factor for mortality, which could contribute to a more detailed prognostic discussion between surgeon and patient before surgery. |
format | Online Article Text |
id | pubmed-5081327 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Korean Society of Spine Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-50813272016-10-27 Surgical Management in Elderly Patients with Tuberculous Spondylodiscitis: Ten Year Mortality Audit Study Kothari, Manish Kundanmal Shah, Kunal Chandrakant Tikoo, Agnivesh Nene, Abhay Madhusudan Asian Spine J Clinical Study STUDY DESIGN: Retrospective study. PURPOSE: To evaluate the factors affecting immediate postoperative mortality in elderly patients with tuberculous spondylodiscitis. OVERVIEW OF LITERATURE: Treatment of spinal tuberculosis in the elderly involves consideration of age and co-morbidities, and often leads to an extended conservative management. Surgical intervention in these patients becomes a complex decision. There are no studies on risk factors of mortality in surgically treated elderly with tuberculous spondylodiscitis. METHODS: Two hundred and seventy-six patients with spondylodiscitis were operated between 2005 and 2015. 20 consecutive patients over 70 years of age with and proven tuberculosis who met the inclusion/exclusion criteria were included. Demographic, clinical and radiological profile data with operative details of instrumentation, blood loss, surgical duration, and mortality were noted. There were 20 patients (6 males, 14 females) with a mean age of 73.5 years. The patients were divided into those with mortality (M) and those who survived (non-mortality, NM). Various variables were statistically tested for immediate postoperative medical complications and mortality. RESULTS: There were four mortalities (20%). Age, sex, number of medical co-morbidities, American Society of Anaesthesiologists grade, Frankel grade C or worse, number of vertebrae involved, number of levels fused, blood loss and operative time did not have statistically significant impact on immediate postoperative mortality. Only preoperative immobility duration was statistically higher in the M group (p=0.016) than in the NM group. CONCLUSIONS: Preoperative immobility is associated with immediate postoperative mortality in elderly patients with spinal tuberculosis undergoing surgery. The findings identify preoperative immobility as a risk factor for mortality, which could contribute to a more detailed prognostic discussion between surgeon and patient before surgery. Korean Society of Spine Surgery 2016-10 2016-10-17 /pmc/articles/PMC5081327/ /pubmed/27790320 http://dx.doi.org/10.4184/asj.2016.10.5.915 Text en Copyright © 2016 by Korean Society of Spine Surgery http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Kothari, Manish Kundanmal Shah, Kunal Chandrakant Tikoo, Agnivesh Nene, Abhay Madhusudan Surgical Management in Elderly Patients with Tuberculous Spondylodiscitis: Ten Year Mortality Audit Study |
title | Surgical Management in Elderly Patients with Tuberculous Spondylodiscitis: Ten Year Mortality Audit Study |
title_full | Surgical Management in Elderly Patients with Tuberculous Spondylodiscitis: Ten Year Mortality Audit Study |
title_fullStr | Surgical Management in Elderly Patients with Tuberculous Spondylodiscitis: Ten Year Mortality Audit Study |
title_full_unstemmed | Surgical Management in Elderly Patients with Tuberculous Spondylodiscitis: Ten Year Mortality Audit Study |
title_short | Surgical Management in Elderly Patients with Tuberculous Spondylodiscitis: Ten Year Mortality Audit Study |
title_sort | surgical management in elderly patients with tuberculous spondylodiscitis: ten year mortality audit study |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5081327/ https://www.ncbi.nlm.nih.gov/pubmed/27790320 http://dx.doi.org/10.4184/asj.2016.10.5.915 |
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