Publication: Resección de meningiomas intracraneales en el anciano: factores relacionados con la mortalidad y morbilidad postoperatorias
Loading...
Files
Official URL
Full text at PDC
Publication Date
2017-10-04
Authors
Advisors (or tutors)
Editors
Journal Title
Journal ISSN
Volume Title
Publisher
Universidad Complutense de Madrid
Citations
Exportar
Abstract
Los meningiomas son el tumor intracraneal diagnosticado con más frecuencia, y son el segundo en frecuencia en precisar tratamiento quirúrgico. La incidencia de estos tumores aumenta de forma progresiva con la edad, en particular a partir de los 65 años. El envejecimiento poblacional, junto con el uso generalizado de los estudios de neuroimagen, han llevado a que la práctica de la neurocirugía confronte con frecuencia el abordaje de un paciente anciano diagnosticado de un meningioma intracraneal. La toma de decisiones en estos pacientes ha de basarse en el conocimiento de los riesgos y las expectativas de beneficio que la cirugía les pueda acarrear. El envejecimiento fisiológico se asocia a una pérdida progresiva de la reserva funcional de múltiples sistemas del organismo, lo que deriva en una menor tolerancia a situaciones de estrés menor. Este estado se ha definido como fragilidad, y se caracteriza por una mayor mortalidad, morbilidad y necesidad de cuidados en relación con la enfermedad oncológica y los tratamientos quirúrgicos. La edad avanzada se asocia a una peor evolución tras los procedimientos quirúrgicos, que en parte es secundaria a la comorbilidad asociada, pero en parte se debe a la influencia de la edad como factor independiente...
Meningiomas are the most commonly diagnosed intracranial tumour, and are the second in frequency among those requiring surgical treatment. Incidence of meningiomas has been shown to increase with age, particularly after the 7th decade of life. Demographic changes and the widespread use of neuroimaging techniques have brought into frequent daily practice the approach to elderly patients diagnosed of an intracranial meningioma. The exact knowledge of the expected risks and benefits carried by surgery are essential for decision-making and informed consent. Physiologic aging is associated to the progressive loss of functional reserve in all body systems, which leads to diminished tolerance to minor stressors. This situation has been called “frailty”, and is characterized by increased mortality, morbidity and health related expenses after oncologic disorders and surgical treatment. Advancing age is related to a worse outcome after surgery secondarily to increased comorbidity but also due to the independent influence of age as a risk factor. The effect of advanced age in neurosurgery is related to a worse prognosis after subarachnoid hemorrhage, severe traumatic brain injury and brain gliomas. In the field of neurology it is also related to poor outcome after ischemic and hemorrhagic stroke...
Meningiomas are the most commonly diagnosed intracranial tumour, and are the second in frequency among those requiring surgical treatment. Incidence of meningiomas has been shown to increase with age, particularly after the 7th decade of life. Demographic changes and the widespread use of neuroimaging techniques have brought into frequent daily practice the approach to elderly patients diagnosed of an intracranial meningioma. The exact knowledge of the expected risks and benefits carried by surgery are essential for decision-making and informed consent. Physiologic aging is associated to the progressive loss of functional reserve in all body systems, which leads to diminished tolerance to minor stressors. This situation has been called “frailty”, and is characterized by increased mortality, morbidity and health related expenses after oncologic disorders and surgical treatment. Advancing age is related to a worse outcome after surgery secondarily to increased comorbidity but also due to the independent influence of age as a risk factor. The effect of advanced age in neurosurgery is related to a worse prognosis after subarachnoid hemorrhage, severe traumatic brain injury and brain gliomas. In the field of neurology it is also related to poor outcome after ischemic and hemorrhagic stroke...
Description
Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 18/01/2016