Early Morbidity and Mortality in 50 Very Elderly after Posterior Atlantoaxial Fusion for XXXX .

@entity1 @entity174 @entity55 @entity86 @entity1282 @entity531
BACKGROUND: @entity174 ( @entity174 ) in the very elderly are associated with a high morbidity and mortality. The best treatment strategy (conservative vs. surgery) is still unclear. METHODS: Between April 2008 and April 2014 fifty (17 male / 33 female) @entity1 (mean age 87.2    4.4 years; range: 80-99) were included in this retrospective cohort study. All @entity1 underwent posterior fusion surgery for @entity174 . Early outcome, morbidity and mortality, length of hospital and ICU stay, comorbidities and perioperative complications were assessed. RESULTS: The mean age-adjusted Charlson Comorbidity Index (CCI) was 5.8    3.9 (range: 0-13), the mean ASA score 3    0.5 (range: 2-4). Surgery was delayed in 48% of @entity1 : In 30% because of preoperative complications (72.4% severe) of which one leading cause was @entity1282 with subsequent @entity55 ; 18% required preoperative assessment or improvement of health status. Surgery-related complications were experienced in 14% with no @entity531 . Postoperative medical complications had 52% of @entity1 (67.3% severe). Major complications were mostly respiratory/pulmonary (66.7%) of @entity86 (36.4%) was leading. Twenty-four percent of @entity1 were ICU monitored. Mean length of ICU stay was 9    6.6 days (1-20). Mean length of hospital stay was 15    8.6 days (4-56). There was no in-hospital mortality and 30-day mortality was 6%. CONCLUSIONS: Posterior fusion for @entity174 in @entity1 80 years or older seems to be a feasible treatment option in these high risk @entity1 . Despite a high incidence of severe comorbidities and perioperative complications outcome was satisfactory. LEVEL OF EVIDENCE: Retrospective cohort study; Level III.
