title: [Neurosurgery in the elderly patient: Geriatric neurosurgery].
abstract: OBJECTIVE
  Between 2000 and 2050, the proportion of the world's population over 60 years will double, and the number of people aged 80 and older will quadruple. Health professional training does not include instructions about specific care for older people. The World Health Organization maintains that all health providers should be trained on ageing issues. Thus, it is proposed to analyse the effect of ageing on Neurosurgery in our country.
  
  
  METHODS
  A retrospective historical cohort study was performed on individuals age 70 years or older admitted to the Neurosurgery or the Intensive Care Unit of our hospital, with neurosurgical disease, between two periods: 1999-2000 and 2010-2011. An analysis was made on variables such as: age, pathology, length of stay, comorbidity, performance status, re-admissions and mortality.
  
  
  RESULTS
  Similar numbers of patients were admitted during the two periods: 409 and 413. However, there was an increase of 77.5% in patients older than 70 years: 80 versus 142. Statistically significant differences were observed in the Charlson Comorbidity Index, the admission Glasgow Coma Scale (GCS) score, length of stay, and re-admissions. Comorbidity and admission GCS score were particularly worse in the second period. Nevertheless, the mean length of stay was lower in that period, but showing more hospital re-admissions. After multivariate analysis, it was observed that re-admissions were associated with comorbidity, but not with early hospital discharge. No differences were found in performance status or mortality.
  
  
  CONCLUSIONS
  A very considerable increase in percentage of patients older than 70 years old was found. There were no differences in performance status or mortality, which was probably due to the multidisciplinary management of these patients. The results of this study support the development of an interdisciplinary work group dedicated to Geriatric Neurosurgery.
authors.affiliation: Servicio de Neurocirugía, Hospital General Universitario de Castellón. Facultad de Ciencias de la Salud, Unidad Pre-departamental de Medicina, Universidad Jaume I de Castellón, Castellón, España. Electronic address: luisgermangb@hotmail.com.
authors.forename: Luis Germán
authors.initials: LG
authors.lastname: González-Bonet
authors.affiliation: Unidad de Geriatría, Servicio de Medicina Interna, Universidad Católica de Valencia, Valencia, España.
authors.forename: Francisco-José
authors.initials: FJ
authors.lastname: Tarazona-Santabalbina
authors.affiliation: Unidad docente, Hospital General Universitario de Castellón. Outcomes Research Group, Universidad Jaume I de Castellón, Castellón, España.
authors.forename: Luis
authors.initials: L
authors.lastname: Lizán Tudela
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000601:surgery*; D019635:Neurosurgical Procedures; D012189:Retrospective Studies
keywords: Ageing; Brain neoplasms; Craniocerebral trauma; Envejecimiento; Espondilosis; Geriatrics; Geriatría; Neurocirugía; Neurosurgery; Spondylosis; Trauma craneocerebral; Tumores cerebrales