Surgery in Elderly People
Anesthetic Considerations And Operative Issues, Perioperative Pain Management, Delirium And Postoperative Cognitive Dysfunction, Other Complications
Surgery on elderly people was once uncommon, but as the population has aged it has become much more frequent. There has also been a change in who is thought of as old, and studies based on someone sixty-five years old provide incomplete insight into the issues surrounding appropriate therapies for the ‘‘new’’ geriatric patient.
The traditional view of risk for surgical procedures has focused more on chronological than biological age. Advanced age has generally been considered to carry a higher risk of illness and complications (morbidity), and of death (mortality). In consequence, life-saving procedures such as cardiac, vascular, or oncology procedures can be delayed or withheld. However, relying on age alone to determine a patient’s response to surgery can be inappropriate.
Chronological age can, of course, serve as a marker for increased physiological frailty. Frail older adults (the ‘‘new’’ geriatric patient) frequently suffer from multisystem disease, several comorbidities, and polypharmaceutic regimens (an excessive number of medications). Frailty implies not just lower reserve capacity, but also an interaction of social and medical problems. In consequence, the decision to perform surgery should be multidisciplinary in nature, encompassing not only the suitability to withstand the stress of surgery, but also the rehabilitation and social supports required for hospital discharge.
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- Surgery in Elderly People - Anesthetic Considerations And Operative Issues
- Surgery in Elderly People - Perioperative Pain Management
- Surgery in Elderly People - Delirium And Postoperative Cognitive Dysfunction
- Surgery in Elderly People - Other Complications
- Surgery in Elderly People - Surgical Intensive Care
- Surgery in Elderly People - Rehabilitation
- Surgery in Elderly People - Conclusion
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