Adverse events in 50 consecutive cases of chronic bilateral STN DBS for Parknson's dsiease: a basis for a risk management strategy
Détails
ID Serval
serval:BIB_44F1B8C57C5A
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Institution
Titre
Adverse events in 50 consecutive cases of chronic bilateral STN DBS for Parknson's dsiease: a basis for a risk management strategy
Titre de la conférence
XVth Congress of the European Society for Stereotactic and Functional Neurosurgery
Adresse
Toulouse, France, on October, 9-12, 2002
Statut éditorial
Publié
Date de publication
2002
Volume
144
Série
Acta Neurochirurgica
Pages
1071
Langue
anglais
Résumé
Objectives: Identify and determine the frequency of adverse events related to STN-DBS for PD in a risks management strategy project.
Materials and Methods: Data from fifty consecutive patients were prospectively collected. Follow-up ranged from 5 to 36 months (median 17). There were 30 males and 20 females. Disease duration was 13G5 yearsand age at surgery 64G8. Pre-operative scores: Hoehn and Yahr OFF 3.4 G0.8, ON 2.5 G0.7; UPDRS OFF 46.8G14.4, ON 24.8G9.3; ADL 11 G5.2; dyskinesia 5.3 G2.4; fluctuations 3.9 G1.4. Pre-operative medication 1100 mgG500 mg ELD. Localization waswith MRI, and CRW frame wasused. One tract microelectrode recording obtained in most; macrostimulation carried out in 49; four daystrial stimulation in all; all patientsreceived per-operative antibiotic. A post-operative MRI obtained within 24 hours.
Results: Electrodesplacement took 3 h 50 m, and generator 1 h 10 m. Complicationswere: one frame displacement and two electrodes malposition leading to repositioning; one air embolus; one seizure and one panic crisis requiring rescheduling; one delayed infection and two connector wounds dehiscence requiring surgery; six transient confusional state. There was no hemorrage. Post-operative scores: UPDRS 27.7G11.6; ADL 12.7G6.7; dyskinesia 0.5G1.4; fluctuations0.3 G0.9. Twenty two patientsremained drug free; medication was decreased by 55% in the others. Conclusion: Identification and analysis of adverse events is a necessary step in surgical risks management. According to our surgical population and methodology, we confirm that the risk benefit ratio of STN-DBS in PD islow, and might improve further with some changesin management.
Materials and Methods: Data from fifty consecutive patients were prospectively collected. Follow-up ranged from 5 to 36 months (median 17). There were 30 males and 20 females. Disease duration was 13G5 yearsand age at surgery 64G8. Pre-operative scores: Hoehn and Yahr OFF 3.4 G0.8, ON 2.5 G0.7; UPDRS OFF 46.8G14.4, ON 24.8G9.3; ADL 11 G5.2; dyskinesia 5.3 G2.4; fluctuations 3.9 G1.4. Pre-operative medication 1100 mgG500 mg ELD. Localization waswith MRI, and CRW frame wasused. One tract microelectrode recording obtained in most; macrostimulation carried out in 49; four daystrial stimulation in all; all patientsreceived per-operative antibiotic. A post-operative MRI obtained within 24 hours.
Results: Electrodesplacement took 3 h 50 m, and generator 1 h 10 m. Complicationswere: one frame displacement and two electrodes malposition leading to repositioning; one air embolus; one seizure and one panic crisis requiring rescheduling; one delayed infection and two connector wounds dehiscence requiring surgery; six transient confusional state. There was no hemorrage. Post-operative scores: UPDRS 27.7G11.6; ADL 12.7G6.7; dyskinesia 0.5G1.4; fluctuations0.3 G0.9. Twenty two patientsremained drug free; medication was decreased by 55% in the others. Conclusion: Identification and analysis of adverse events is a necessary step in surgical risks management. According to our surgical population and methodology, we confirm that the risk benefit ratio of STN-DBS in PD islow, and might improve further with some changesin management.
Création de la notice
11/12/2013 23:54
Dernière modification de la notice
20/08/2019 13:49
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