Preoperative Pulmonary Evaluation and Evaluation of Postoperative Pulmonary Complications in Geriatric Patients Undergoing Spinal Surgery

Background: The number of elderly (geriatric) population is increasing day by day and it becomes important in geriatric diseases and surgeries. It is predicted that approximately half of the population over the age of 65 will require surgical intervention during their lifetime in western societies in the following years. For this reason, he wanted to show that postoperative morbidity and mortality can be reduced with a careful preoperative pulmonary evaluation in this patient group, which we now encounter more frequently in pulmonology practice. Objective: We aimed to examine the preoperative pulmonary risk assessment and the type of operation performed in geriatric patients who underwent spinal surgery, and its effect on postoperative complications and mortality in relation to the geriatric age group of the patient in the light of the literature. Methods: Preoperative and postoperative consultations of 341 geriatric spinal surgery patients were retrospectively reviewed. Geriatric age group, gender, existing diseases, preoperative pulmonary risk class, type and duration of surgery, type of anesthesia (all patients were operated under general anesthesia), peroperative and postoperative complications were recorded. Results: The mean age was 75.28 ± 6.091 (65 93). . When the patients with chronic disease in the preoperative period and died in the post operative period were evaluated, a statistically significant difference was observed in the elderly group in terms of mortality rates in the presence of malignancy alone, COPD or CHF disease compared to other age groups. Postoperative respiratory complications were observed in 35 (10.3%) patients. Respectively, 13 (3.81%) patients had pneumonia, 12 (3.51%) patients had atelectasis, 7 (2.05%) patients had embolism, and 3 (0.87%) patients had respiratory failure. There was a statistically significant increase in mortality rate in postoperative complications and death rates in direct proportion to age. Conclusions: These complications can be minimized by better pulmonary preoperative risk assessment.Keywords: Spinal surgery in geriatric patients, Preoperative pulmonary evaluation, Postoperative pulmonary risk 'DOI: 10.7176/JHMN/78-0

Evaluation of the neurosurgical events with detailed demographic factors in pediatric traumas

In this study, we aimed to investigate the incidence of neurosurgical events in patients with childhood trauma to determine risk factors and to standardize the neurosurgical approach to pediatric trauma for reducing the request of unnecessary tomography imaging. According to the age distribution of children aged 17 and under who applied to the emergency department from Jan 2019 to Jan 2021 was examined in 3 separate groups; the infant-early childhood group (0-3 years old), the preschool group (4-7 years), and the pre-adolescence and adolescence group (8-17). Radiological images, type of trauma, neurosurgical damage of trauma (spinal, cranial) and treatment approaches were examined. The mean age of 1247 pediatric trauma patients admitted to the emergency department within two years was 7.71 ± 5.01. The most common reasons in terms of trauma etiology were found to be falling from height (61.2%), traffic accidents (26.5%), and then running into a hard object (10%). It was determined that 249 (19.3%) of the patients were consulted to the Neurosurgery department and 128 patients were hospitalized to the neurosurgery service due to spinal (n: 29) and cranial (n: 99) events. 11 of these patients were operated due to cranial, 2 to spinal events and a patient with spinal injury was followed up with conservative treatment due to SCIWORA (spinal cord injury without radiographic abnormalities). Although trauma is the most important cause of mortality and morbidity in the pediatric age group, most of them are preventable. Computed tomography (CT) indications for pediatric head/spinal traumas are still controversial. We think that unnecessary CT usage should be avoided as much as possible, although there is a need for imaging in order not to miss the diagnosis of severe traumatic brain injury. [Med-Science 2022; 11(1.000): 25-30