Advanced age [Neurosurgery Wiki]

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=====Advanced age=====
While advanced age is already recognized as an independent risk factor for a poor [[functional outcome]] following an [[aneurysmal subarachnoid hemorrhage]] (SAH), it is also important to investigate the critical age for defining a higher risk population among elderly patients and the clinical grade at admission in order to provide a prognostic description and help guide the management of patients aged ≥ 70 years.  
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In a study of Senders et al. from [[Boston]] and [[Utrecht]], patients were extracted from the [[National Surgical Quality Improvement Program]] registry (2005-2015) and analyzed using [[multivariable]] [[logistic regression]].

A total of 7376 [[patient]]s were identified, of which 948 (12.9%) experienced a major [[complication]]. The most common major complications were [[reoperation]] (5.1%), [[venous thromboembolism]] (3.5%), and [[death]] (2.6%). Furthermore, 15.6% stayed longer than 10 d, and 11.5% were readmitted within 30 d after surgery. The most common reasons for reoperation and [[readmission]] were [[intracranial hemorrhage]] (18.5%) and [[wound]]-related complications (11.9%), respectively. Multivariable analysis identified older [[age]], higher [[body mass index]], higher American Society of Anesthesiologists ([[ASA]]) classification, dependent [[functional]] status, elevated preoperative [[white blood cell]] count (white blood cell count [[WBC]], >12 000 cells/mm3), and longer operative time as predictors of major complication (all P < .001). Higher ASA classification, dependent [[functional]] status, elevated [[WBC]], and [[ventilator]] dependence were predictors of extended length of stay (all P < .001). Higher ASA classification and elevated WBC were predictors of reoperation (both P < .001). Higher ASA classification and dependent functional status were predictors of readmission (both P < .001). Older age, higher ASA classification, and dependent functional status were predictors of death (all P < .001).

This study provides a descriptive analysis and identifies predictors for short-term complications, including death, after craniotomy for primary malignant brain tumors
((Senders JT, Muskens IS, Cote DJ, Goldhaber NH, Dawood HY, Gormley WB, Broekman
MLD, Smith TR. Thirty-Day Outcomes After Craniotomy for Primary Malignant Brain
Tumors: A National Surgical Quality Improvement Program Analysis. Neurosurgery.
2018 Dec 1;83(6):1249-1259. doi: 10.1093/neuros/nyy001. PubMed PMID: 29481613.
)).