Hi, I'm Andrew Joaquim, I'm a 3rd year medical student at Creighton University, and I did this research in collaboration with Barrow Neurological Institute, all in Phoenix, Arizona. So this project is called Advanced Age Does Not Increase Risk of Postoperative Complications Following Deep Brain Stimulation Surgery. So a quick intro, DBS is used to treat motor symptoms of movement disorders. And while these disorders, such as Parkinson's disease, commonly occur in advanced age, age also brings with it deteriorating health. So we performed this study to analyze whether advanced age is an independent risk factor for negative outcomes following deep brain stimulation. So this study is a retrospective analysis of 861 patients who underwent DBS at BNI by Dr. Ponce between May 2013 and July 2019. Patients were stratified by age, either 75 or older, or younger than 75, and the outcomes were compared. This table shows our patient characteristics. As you can see, the age was significantly different between the two groups, and they were matched for sex. A similar proportion of each group was treated for Parkinson's disease, however, a significantly higher proportion of patients in the elderly group were treated for essential tremor, whereas a significantly greater portion of patients in the younger group were treated for either dystonia or another disease. What we found was that the rate of seizures, strokes, infections, placement in the ICU or remission within 90 days were very similar between the two groups. However, we found that the elderly patients were more likely to experience altered mental status following surgery, urinary retention during their hospital stay, discharge to a place other than home, or greater than a one-night hospital stay. When we compare intracranial hemorrhage between the two groups, it appears as though there is an increased risk to experience intracranial hemorrhage following DBS in the elderly. However, our p-value is .06, so I do want to discuss further some of these outcomes. So for intracranial hemorrhage, when we broke it down into the type of bleed, the elderly were only at an increased risk of experiencing a subdural hemorrhage. Future studies will go a little bit more in depth in this and look at when these bleeds were diagnosed, whether they were symptomatic or not, how they resolved with or without treatment to give us a better understanding of the severity of these findings. Patients in the younger group were more likely to be discharged to home, and patients in the older group were more likely to be discharged to either a rehab or a SNF. As I stated earlier, elderly patients were more likely to spend more than one night in the hospital than younger patients. When we looked at the reasons for it, it was not due to any focal neurological deficit, any medical change like CHF exacerbation, or anything like that. The largest reason was just because of their age. There was a lower threshold to keep them more than one night, mainly for observation. So in conclusion, elderly patients were found to be at an increased risk of certain outcome measures related to a prolonged recovery. However, complication rates that would question the safety of performing DBS on the elderly were not found to be increased as a result of age. Future studies that we would like to perform would consider things like the generalizability of these findings, since these findings apply to one institution, one surgeon, over a six year time span, as well as a further understanding of these perioperative bleeds. Were they symptomatic? Were they harmful? Did they resolve? How did they resolve? As well as long-term outcomes, such as comparing efficacy between the two groups. All right, I really thank everyone for watching this. Thank you for your time. If you have any questions, please feel free to email me. Thanks.

deep brain stimulation surgery

elderly patients

intracranial hemorrhage risk

retrospective analysis

long-term efficacy