• Emily R Bligh, Priyank Sinha, Daisy Smith, and Yahia Z Al-Tamimi.
• Faculty of Medicine, Dentistry and Health, University of Sheffield Medical School, Sheffield, United Kingdom.
• World Neurosurg. 2020 Jan 1; 133: e646-e652.

ObjectivesWith an aging population and advances in neuroanesthesia and critical care, an increasing subgroup of elderly patients have been undergoing neurosurgery. Of particular relevance is the cohort aged >80 years. The aim of the present study was to investigate the 30-day mortality and survival in this cohort after emergency and elective neurosurgery.MethodsWe performed a retrospective cohort study of all patients aged ≥70 years who had undergone a neurosurgical procedure from 2015 to 2017. The patient demographic data were identified, and independent predictors were found using logistic regression analysis.ResultsA total of 796 patients were included, of whom 622 were aged <80 years (group A) and 174 were aged >80 years (group B). Overall survival was 86.3% in group A and 79.9% in group B. The 30-day mortality between the elective (0.8%) and emergency (10.1%) patients was significantly different statistically (P < 0.001). Of the patients in groups A and B, 84.7% and 68.9% were discharged back to their usual residence, respectively. Logistic regression found emergency surgery to be an independent predictor of mortality.ConclusionsThe current model for accepting elderly patients has been associated with good overall outcomes. The elderly should not be refused neurosurgery on the basis of their age alone. However, we applied fairly strict criteria, especially for those with subarachnoid hemorrhage, which should be factored into our results.Copyright © 2019 Elsevier Inc. All rights reserved.

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