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Neurophysiological Intraoperative Monitoring in the Elderly.

Lilia C De la Maza Krzeptowsky1, Daniel San-Juan1,2, Cecilia Ximénez Camilli3

  • 1Neurophysiology Department, Hospital Ángeles del Pedregal, México City, Mexico.

Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society
|March 7, 2020
PubMed
Summary
This summary is machine-generated.

Elderly patients undergoing intraoperative neurophysiological monitoring (IONM) show similar signal changes compared to younger adults. This finding suggests IONM is equally effective across age groups for preventing nervous system injury during surgery.

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Area of Science:

  • Neurosurgery
  • Neurology
  • Geriatrics

Background:

  • Intraoperative neurophysiological monitoring (IONM) is crucial for preventing nervous system injury in elderly surgical patients.
  • Limited research exists on IONM characteristics and changes in patients aged 60 and older.
  • This study addresses the gap by comparing IONM in elderly versus younger adult surgical patients.

Purpose of the Study:

  • To describe and compare intraoperative neurophysiological monitoring (IONM) changes in elderly patients (60+ years) versus younger adults (18-59 years).
  • To evaluate the effectiveness of IONM across different age groups during various surgical procedures.

Main Methods:

  • A retrospective comparative study analyzed 195 patients (104 elderly, 91 younger) who underwent IONM from 2013-2018.
  • Sociodemographic data, IONM techniques, signal changes, and surgical procedures were compared between age groups.
  • Statistical analyses included descriptive statistics, Mann-Whitney U, Fisher, and chi-squared tests; sensitivity, specificity, and predictive values were calculated.

Main Results:

  • No significant differences were observed in the rates of signal changes during IONM between the elderly and younger patient groups.
  • The overall sensitivity, specificity, and predictive values for IONM were high, indicating reliable monitoring.
  • Elderly patients (mean age 68.63 years) and younger patients (mean age 42.3 years) exhibited comparable IONM responses.

Conclusions:

  • Elderly patients demonstrate a similar rate of intraoperative neurophysiological monitoring signal changes compared to younger patients.
  • IONM is an effective monitoring tool across a broad age spectrum, including older adults.
  • These findings support the continued use of IONM for safeguarding nervous system integrity in elderly surgical populations.