05 Profile of a Geriatric Neurosurgical Service

Abstract

Abstract Background According to the 2016 CSO figures the age category of 65 and older saw the largest increase in the Irish population since 2011, rising by 102,174 to 637,567, a rise of 19.1%. This remains a major concern for a North Dublin teaching hospital as its catchment area has a 20% higher proportion of > 65’s and > 85’s than the national average. This catchment area profile has the potential to impact on the profile of the in-catchment admissions while the National profile will impact on the national specialities including neurosurgery. Aim To profile the geriatric neurosurgical population and provide insight that facilitates future service planning and delivery. Methods To accurately capture the data, all ward lists for the month of June and July 2017 were reviewed to identify appropriate patients. All patients on any ward within the hospital, under the care of a neurosurgeon, were included in the data collection. Patients in intensive care that did not transfer to the wards were excluded. Data points including age, sex, consultant, co-morbidities, mobility status and surgical intervention were captured. Results 120 patients ≥ 65 years were admitted to the neurosurgical service between June and July 2017; 45 (38%) between 60-69, 60 (50%) 70-79, 13(10%) 80-80 and two (2%) ninety years or older. The two most common reasons for admission were non-traumatic cerebral bleeds (N= 40; 34%) and cerebral tumours (N= 38; 32%). Patients had on average four co-morbidities, with cardiac being the most common. 17 patients were admitted post a traumatic event; 13 low impact falls, 3 high impact falls and one assault. The average LOS for these patients was 11.3 days. Conclusion This profile highlights the complex needs of this population and the increasing burden on existing neurosurgical resources as the population continues to age. Future resource allocation and service development, including the National Trauma Strategy, needs to consider the needs of the aging neurosurgical population.