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Comprehensive geriatric assessment to predict adverse events in elderly patients undergoing posterior lumbar fusion surgery – Lumbar Fusion

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A study published in the European Spine Journal aimed to investigate the impact of comprehensive geriatric assessment (CGA) on adverse events in elderly patients undergoing posterior lumbar fusion surgery. The CGA included various components such as activities of daily living, nutritional status, cardiac function, frailty, cognition, anxiety, and comorbidity. The study found that female patients were more susceptible to adverse events. Postoperative major adverse events were associated with delirium, nutritional status, cognitive impairment, Charlson comorbidity index (CCI), and severe dependency. Further analysis showed that delirium and CCI were independently related to major adverse events. The results highlight the importance of preoperative screening and addressing delirium, cognitive function, nutrition, and comorbidity to prevent postoperative complications in elderly surgical patients

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

S: These results indicate that preoperative screening preoperative delirium, cognitive, nutrition and CCI are essential to prevent postoperative major AEs of the surgical elderly.

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Eur Spine J. 2023 Sep 21. doi: 10.1007/s00586-023-07945-5. Online ahead of print.ABSTRACTPURPOSE: Although comprehensive geriatric assessment (CGA) has been used widely, its impact on adverse events in elderly patients has not been fully examined. The present study aimed to investigate the relationships between subcomponents of CGA and adverse events (AEs) in elderly patients undergoing posterior,

Eur Spine J. 2023 Sep 21. doi: 10.1007/s00586-023-07945-5. Online ahead of print.

ABSTRACT

PURPOSE: Although comprehensive geriatric assessment (CGA) has been used widely, its impact on adverse events in elderly patients has not been fully examined. The present study aimed to investigate the relationships between subcomponents of CGA and adverse events (AEs) in elderly patients undergoing posterior lumbar fusion surgery.

METHODS: A total of 242 eligible elderly patients enrolled. Our CGA included activities of daily living, instrumental activities of daily living, nutritional status, cardiac function, pulmonary function, renal function, frailty, cognition, anxiety, depression, delirium, chronic pain score, comorbidity and polypharmacy. Comprehensive complication index was used to summarize postoperative complications and its severity. Logistic regression was performed to determine the relationships between subcomponents of a CGA and postoperative AEs.

RESULTS: Present study found that female were more vulnerable to have AEs. Postoperative major AEs were associated with delirium (odds ratio (OR): 4.302, 95% confidence interval (CI) 1.720-10.761, p = 0.002), nutritional status (OR: 3.030, 95%CI 1.218-7.541, p = 0.017), cognitive impairment (OR: 4.122, 95%CI 1.179-14.407, p = 0.027), Charlson comorbidity index (CCI) (OR: 4.800, 95%CI 1.852-12.440, p = 0.001) and severe dependent (OR: 3.772, 95%CI 1.116-9.841, p = 0.007). Further analysis showed that delirium (OR: 2.824, 95%CI 1.068-7.467, p = 0.036) and CCI (OR: 3.221, 95%CI 1.184-8.766, p = 0.022) were independently related to major AEs.

S: These results indicate that preoperative screening preoperative delirium, cognitive, nutrition and CCI are essential to prevent postoperative major AEs of the surgical elderly.

PMID:37735216 | DOI:10.1007/s00586-023-07945-5

The London Spine Unit : best recognised day surgery unit in UK

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Comprehensive geriatric assessment to predict adverse events in elderly patients undergoing posterior lumbar fusion surgery

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Eur Spine J. 2023 Sep 21. doi: 10.1007/s00586-023-07945-5. Online ahead of print.ABSTRACTPURPOSE: Although comprehensive geriatric assessment (CGA) has been used widely, its impact on adverse events in elderly patients has not been fully examined. The present study aimed to investigate the relationships between subcomponents of CGA and adverse events (AEs) in elderly patients undergoing posterior

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