Neurophysiological Intraoperative Monitoring in the Elderly.

Autor:	De la Maza Krzeptowsky LC; Neurophysiology Department, Hospital Ángeles del Pedregal, México City, Mexico., San-Juan D; Neurophysiology Department, Hospital Ángeles del Pedregal, México City, Mexico.; Neurology Department, National Institute of Neurology, Mexico City, Mexico., Ximénez Camilli C; Hospital Médica Sur, Mexico City, Mexico; and., Alvarez Perera LÁ; Neurophysiology Department, Hospital Ángeles del Pedregal, México City, Mexico.; Neurology Department, National Institute of Neurology, Mexico City, Mexico., Valdez Ruvalcaba H; Neurology Department, National Institute of Neurology, Mexico City, Mexico., Morales Báez JA; Neurophysiology Department, Hospital Ángeles del Pedregal, México City, Mexico., Anschel DJ; Comprehensive Epilepsy Center of Long Island, Port Jefferson, New York, U.S.A.
Jazyk:	angličtina
Zdroj:	Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society [J Clin Neurophysiol] 2021 May 01; Vol. 38 (3), pp. 231-236.
DOI:	10.1097/WNP.0000000000000689
Abstrakt:	Introduction: Intraoperative neurophysiological monitoring (IONM) is widely used to prevent nervous system injury during surgeries in elderly patients. However, there are no studies that describe the characteristics and changes in neurophysiological tests during the IONM of patients aged 60 years and older. The study aims to describe and compare IONM changes during surgeries in adult patients aged 18 to 59 years with those aged 60 years and older. Methods: We performed a comparative retrospective study of patients aged 18 to 59 years versus those 60 aged years and older who underwent IONM during 2013 to 2018 in Mexico City. Sociodemographic characteristics were recorded and compared. Intraoperative neurophysiological monitoring techniques, their changes, and surgical procedures for both groups were analyzed and compared using descriptive statistics, Mann-Whitney U, Fisher, and χ2 tests. The sensitivity, specificity, and positive and negative predictive values were calculated. Results: In total, 195 patients were analyzed: 104 patients, 68.63 ± 6.54 years old (elderly group) and 91 patients, 42.3 ± 10.5 years old (younger group). No differences were found in the rates of signal change during IONM between the group of elderly patients and the younger group. The sensitivity, specificity, and positive and negative predictive values were 80%, 99%, 80%, and 99%, respectively. Conclusions: Elderly patients have a similar rate of changes in IONM signals compared with younger patients during heterogeneous surgeries guided by IONM. Competing Interests: The authors have no funding or conflicts of interest to disclose. (Copyright © 2020 by the American Clinical Neurophysiology Society.)
Databáze:	MEDLINE
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