50岁以上成年人的手术:系统性审查和元分析
Arielle Vary O'Neal1,2, Ishak Tamani1, Christian W Mendo1,3
1Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
Epilepsia
|April 6, 2024
概括
手术对于老年人来说是有效的,有70.1%的人实现了无发作. 虽然老年人面临更高的并发症风险,但经过仔细选择的患者可以从这种治疗中受益.
科学领域:
- 神经外科 神经外科
- 发病学 (Epileptology) 是一个专业的学科.
- 老年医学 老年医学
背景情况:
- 手术未得到充分利用,特别是在老年人中.
- 关于手术在50岁及以上个体的疗效和安全性的证据有限,缺乏共识.
研究的目的:
- 系统评估50岁及以上耐药性患者切除性手术的疗效和安全性.
主要方法:
- 对1990年以后发表的研究进行系统审查,至少有10名参与者和6个月的随访.
- 搜索了多个数据库,包括MEDLINE,Embase,CINAHL,PsychInfo和科学网.
- 使用非随机研究方法指数 (MINORS) 仪器评估偏差风险.
主要成果:
- 包括1111名老年人和4111名年轻人对照在11个案例系列和14个队列研究中.
- 在老年人中,合并的发作自由率为70.1%,与年轻人相比 (风险比率=1.05).
- 老年人患任何并发症的风险更高 (风险比率=2.8),其中26.2%患有并发症,包括7.5%的重大并发症.
结论:
- 手术在老年人和年轻人中表现出类似的疗效.
- 接受手术的老年人患上并发症的风险增加.
- 仔细的患者选择对于考虑在50岁以上的个人中进行手术至关重要.
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