Background There is an evolving concern in the management of brain tumors in the elderly. The number of elderly people (aged 65 years or more) increases progressively, and there is a considerable percent of brain tumors affecting this age group. Elderly people may have one or more chronic illnesses that may render cranial surgery of high risk for mortality and morbidity. This study was carried out to evaluate the short-term (30 days) outcome of brain tumor surgery in elderly patients. Results This is a single-institution retrospective study of elderly patients harboring brain tumors who were managed by surgery. The study included 31 patients between 2014 and 2019. Elective and emergency cases were included. The mean age for the study population was 68.29 years. The mean functional status using the Karnofsky Performance Scale (KPS) changed from 58.06 before surgery to 70 after surgery. Meningioma grade I and glioblastoma multiforme (GBM) were the most common neoplasms, 41.9 and 29%, respectively. There was a statistically significant relationship between the mortality and GBM (P value < 0.05) while there was no correlation with concomitant diseases, KPS, or extent of resection (P value > 0.05). Preoperative concomitant diseases were found in 16 patients. Mortality occurred in 11 cases (35.4%). Conclusions Old age by itself should not be a risk factor alone for increasing mortality or morbidity in cranial surgery for patients with brain tumors. Glioblastoma in old patients with poor KPS carries a significant risk for mortality. Further studies with a larger number of patients and inclusion of more variables are required.
Background Osteoporotic vertebral compression fractures constitute a major concern in elderly population who may not tolerate conservative treatment. Although percutaneous vertebroplasty is an alternative minimally invasive procedure that is commonly used nowadays, there is still debate about its efficacy. The study aim is to provide short term experience about efficacy of vertebroplasty for osteoporotic vertebral fractures. Methods Thirty five patients were treated by percutaneous vertebroplasty (the intervention group). The visual analog scale before the intervention (pre VAS), one week after the intervention (post VAS 1), at three months (post VAS 2) after the intervention were compared at each time point with the control group (35 patients). The oswestry disability index before (pre ODI) and three months after the procedure (post ODI) were assessed. The control group received the optimal medical treatment and a regular physiotherapy program for three months. Results Both conservative and vertebroplasty group showed significant improvement in the VAS/ODI with time. With vertebroplasty, the improvement is faster and statistically significant compared with conservative group. There were statistically significant differences between both groups concerning post VAS 1, post VAS 2 and post ODI as the P values were 0.00 in all relationships. Conclusion Patients with osteoporotic compression fractures who were treated with percutaneous vertebroplasty experienced considerable clinical improvement in comparison with those who received the conservative management.
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