title: Impact of age on complications and outcome in meningioma surgery.
abstract: BACKGROUND
  Surgery for benign brain tumors in elderly patients without severe general health problems is an acceptable practice, as results are comparable with the ones of younger patients. Nevertheless, the hypothesis that operative complications and perioperative incidents could differ between the 2 age groups should be controlled; and age-specific strategies in operative technique and perioperative care may be useful.
  
  
  METHODS
  Medical records of 348 patients were reviewed. Demographic data (age, sex), rate of excision, complications of the immediate postoperative period, neurological outcome, and mortality were recorded; and statistical evaluation comparing 2 age groups (19-64 and 65-84 years of age) was performed.
  
  
  RESULTS
  The "young" age group consisted of 240 patients, whereas the "elderly" one had 108. Tumor removal rate was not significantly different in the 2 groups. The elderly age group included significantly more "complicated cases." Regarding each complication, postoperative hematoma, infections, and deep vein thrombosis were more frequent in elderly patients, presenting various degrees of statistical significance, whereas postoperative brain edema, hydrocephalus, and cardiorespiratory incidents presented no statistically significant difference. Finally, more elderly patients presented neurological deterioration, although mortality was not significantly different.
  
  
  CONCLUSIONS
  Operation for intracranial meningioma in elderly patients is justified as long as detailed preoperative evaluation is performed. Planning of modified protocols including intraoperative technical aspects, careful use of steroids antibiotics, and prophylactic low molecular weight heparin, and early mobilization is necessary for optimizing operative outcome of elderly patients.
authors.affiliation: Department of Neurosurgery, University of Athens Medical School, Evangelismos General Hospital, 11521 Athens, Greece. eboviats@med.uoa.gr
authors.forename: Efstathios J
authors.initials: EJ
authors.lastname: Boviatsis
authors.forename: Triantafyllos I
authors.initials: TI
authors.lastname: Bouras
authors.forename: Andreas T
authors.initials: AT
authors.lastname: Kouyialis
authors.forename: Marios S
authors.initials: MS
authors.lastname: Themistocleous
authors.forename: Damianos E
authors.initials: DE
authors.lastname: Sakas
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000209:etiology; D003399:Craniotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008579:Meningioma / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology; D019635:Neurosurgical Procedures; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome