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Perioperative care of elderly patients


Authors: Eva Krpenská;  Kateřina Jandová;  Robert Gürlich
Authors‘ workplace: Chirurgická klinika 3. LF UK a FN Královské Vinohrady, Praha
Published in: Čas. Lék. čes. 2020; 159: 13-16
Category: Review Article

Overview

As life expectancy increases in economically developed countries, there is an increasing need for medical care for the elderly. In surgical fields, this means that the number and spectrum of surgical interventions in elderly patients is increasing. Because of this special attention should be paid to the preoperative evaluation in these patients. Communication with the patient and relatives is crucial in order to decide on the extent of the surgical intervention and whether to treat these patients with curative or palliative intent. It is imperative that physicians understand the physiology of aging and its associated risks, as traditional perioperative risk assessment tools are insufficient in this patient group.

Keywords:

geriatric patient – postoperative complications – frailty – surgery risk – perioperative care


Sources

1. Kwok AC, Semel ME, Lipsitz SR et al. The intensity and variation of surgical care at the end of life: a retrospective cohort study. Lancet 2011; 378: 1408–1413.

2. Gerry RB, Seegmiller JE. Age-related physiological changes and their clinical significance. West J Med 1981; 135(6): 434–440.

3. Dodds C. Physiology of ageing. Anaesth Intensive Care Med 2006; 7: 456–458.

4. Lin HS, McBride, RL, Hubbard RE. Frailty and anesthesia – risks during and post-surgery. Local Reg Anesth 2018; 11: 61–73.

5. Clegg A, Young J, Iliffe S et al. Frailty in elderly people. Lancet 2013; 2; 381(9868): 752–62.

6. Makary MA, Segev DL, Pronovost PJ et al. Frailty as a predictor of surgical outcomes in older patients. J Am Coll Surg 2010; 210(6): 901–908.

7. Fried LP, Tangen CM, Walston J. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56(3): M146–M156.

8. Saxton A, Velanovich V. Preoperative frailty and quality of life as predictors of postoperative complications. Ann Surg 2011; 253(6): 1223–1229.

9. Rockwood K, Mitnitski A. Frailty defined by deficit accumulation and geriatric medicine defined by frailty. Clin Geriatr Med 2011; 27(1): 17–26.

10. Bauer JM, Kaiser MJ, Sieber CC. Evaluation of nutritional status in older persons: nutritional screening and assessment. Curr Opin Clin Nutr Metab Care 2010; 13(1): 8–13.

11. Lee TW, Cho E, Yim ES et al. Activities of daily living in nursing home and home care settings: a retrospective 1-year cohort study. J Am Med Dir Assoc 2015; 16(2): 114–119.

12. White PF, White LM, Monk T et al. Perioperative care for the older outpatient undergoing ambulatory surgery. Anesth Analg 2012; 114(6): 1190–1215.

13. Marik P, Bellomo R. A rational approach to fluid therapy in sepsis. Br J Anaesth 2016; 116(3): 339–349.

14. Green D, Paklet L. Latest developments in peri-operative monitoring of the high-risk major surgery patient. Int J Surg 2010; 8(2): 90–99.

15. Karakoc D. Surgery of the Elderly Patient. Int Surg 2016; 101: 161–166.

16. Desserud KF, Veen T, Søreide K. Emergency general surgery in the geriatric patient. Br J Surg 2016; 103(2): e52–61.

17. Montroni I, Ugolini G, Audisio RA. Principles of cancer surgery in older adults. In: Extermann M (eds.). Geriatric Oncology. Springer, Cham, 2017.

18. Guay J, Kopp S. Epidural pain relief versus systemic opioid-based pain relief for abdominal aortic surgery. Cochrane Database Syst Rev 2016; 1: CD005059.

19. Petersen PL, Mathiesen O, Torup H et al. The transversus abdominis plane block: a valuable option for postoperative analgesia? A topical review. Acta Anaesthesiol Scand 2010; 54(5): 529–35.

20. Yarwood J, Berrill A. Nerve blocks of the anterior abdominal wall. Contin Educ Anaesth Crit Care Pain 2010; 10(6): 182–186.

21. Schlitzkus LL, Melin AA, Johanning JM et al. Perioperative management of elderly patients. Surg Clin North Am 2015; 95(2): 391–415.

22. Ressner P, Konrád J, Bártová P. Delirium u geriatrických nemocných. Neurologie pro praxi 2011; 12(5): 311–316.

23. Dyer CB, Ashton CM, Teasdale TA. Postoperative delirium. A review of 80 primary data-collection studies. Arch Intern Med 1995; 155(5): 461–465.

24. Rosenthal RA, Perkal MF. Physiologic considerations in the elderly surgical patient. In: Miller TA (ed.). Modern surgical care: physiologic foundations and clinical applications. Informa, New York, 2006: 1129–48.

25. Sellers D, Srinivas C, Djaiani G. Cardiovascular complications after non-cardiac surgery. Anaesthesia 2018; 73(1, Suppl.): 34–42.

26. El Solh AA, Ramadan FH. Overview of respiratory failure in older adults. J Intensive Care Med 2006; 21(6): 345–351.

27. Edwards AE, Seymour DG, McCarthy JM et al. A 5-year survival study of general surgical patients aged 65 years and over. Anaesthesia 1996; 51(1): 3–10.

Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management
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