Neurosurgery in octogenarians during the COVID-19 pandemic: results from a tertiary care trauma centre

Agyemang, K., Rose, A., Baig, S., Al Salloum, L., Osman, A. A., Steckler, F. and Barrett, C. (2021) Neurosurgery in octogenarians during the COVID-19 pandemic: results from a tertiary care trauma centre. Interdisciplinary Neurosurgery, 26, 101357. (doi: 10.1016/j.inat.2021.101357) (PMID:34426782) (PMCID:PMC8375277)

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Abstract

Background: In 2020, 6% of Scotland's adult population was ≥80 years. Advancements in care mean improved chances of survival at 6-months for older adults following injury to the brain or spine. The Covid-19 pandemic also resulted in local and national policies aimed at protecting the elderly. We sought to evaluate referral patterns and outcomes for patients ≥80 years referred to our institution during this period. Objective: To evaluate referral patterns and outcomes for patients ≥80 years referred to our institution both before and during the coronavirus pandemic. Design: Retrospective observational cohort study. Setting: Tertiary care in a developing major trauma centre (Queen Elizabeth University Hospital, Glasgow). Participants: All patients ≥80 years referred to the on-call neurosurgical service over two four-month periods before (2016–17; n = 1573) and after the onset of Covid-19 (2020; n = 2014). Methods: Data on demographics, ASA, diagnosis and referral decision were collected. 30-day and 6-month mortality and functional independence were assessed. Results: 246 (before) and 335 (during Covid-19) referred patients were ≥80 years. No gender bias. A significant increase (17%) in acute trauma was seen during the pandemic months. Fewer older adults were transferred (6% to 2% Covid-19) for specialist care, most commonly for chronic subdural haematoma. Most were alive, home and independent at 6 months (47% pre and 63% during Covid-19). Conclusions: Octogenarians feature disproportionately in acute adult neurosurgical referrals. In our department, local and national responses to the Covid-19 pandemic did not appear to influence this. Robust evidence of neurosurgical outcomes in the older adult is required to fairly distribute resources for our ageing population, but decisions must not be based on age alone.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Owusu-Agyemang, Dr Kevin and Rose, Miss Anna and Barrett, Mr Christopher
Authors: Agyemang, K., Rose, A., Baig, S., Al Salloum, L., Osman, A. A., Steckler, F., and Barrett, C.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Interdisciplinary Neurosurgery
Publisher:Elsevier
ISSN:2214-7519
ISSN (Online):2214-7519
Published Online:19 August 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Interdisciplinary Neurosurgery 26: 101357
Publisher Policy:Reproduced under a Creative Commons License

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