Geriatric neurosurgery: Analysis of a single tertiary centre in Hong Kong

Abstract

The elderly aged 80 years and older represent a rapidly growing proportion of Hong Kong’s population. It was 3.1% in 2007 and has increased to 4.9% in 2017. It is expected to further raise to 10% in 2037. A retrospective cross-sectional study was conducted for all neurosurgery admission of aged 80 years and above in Queen Elizabeth Hospital from 1st January 2007 to 31st December 2016. Data was retrieved from Clinical Management System from Hospital Authority. Patient demographics, principal diagnosis, operation performed, perioperative complications, length of stay and mortality were collected and analyzed. A total of 2611 geriatric admissions were included, which accounted for 11.9% of all neurosurgery admission in that period. The majority (51%) of the elderly were admitted for head trauma. There were 397 elderly patients (15.2%) underwent neurosurgical operations. About 1/8 of elderly patients succumbed during the index hospital stay. When we dichotomized this 10-year period, our elderly population increased from 3.5% to 4.5%, however our geriatric admission percentage doubled from 7.8% to 15%. There was increased rate of performing neurosurgical operations on the elderly, from 9.3% rose up to 17.5% (p=0.129). The operation mortality rate dropped from 11.8% to 10.3% (p=0.157) and their average length of stay reduced from 38.9 days to 25 days (p=0.368). There was increasing demand for elderly neurosurgical care in the setting of growing geriatric population in Hong Kong. They were mostly trauma related. Nearly one-fifth of them required neurosurgical interventions. In recent years, we could achieve lower operation mortality rate and shorter length of stay. *Correspondence to: Robert SK Chan, Department of Neurosurgery, Queen Elizabeth Hospital, Hong Kong, E-mail: lwrobert@hotmail.com