Management of postoperative complications: cardiovascular disease and volume management

Area of Science:

• Geriatric Medicine
• Cardiovascular Medicine
• Orthopedic Surgery

Background:

• Postoperative cardiovascular complications are frequent in elderly patients with fractures.
• These complications are often predictable and treatable.
• Limited intervention-specific data exists, necessitating guidelines based on observational evidence and geriatric principles.

Purpose of the Study:

• To establish a basis for treatment guidelines for postoperative cardiovascular complications in geriatric fracture patients.
• To outline safe and effective management strategies.

Main Methods:

• Review of observational evidence from high-performing geriatric fracture centers.
• Application of geriatric principles to patient management.
• Focus on close attention to intravascular volume status, heart rate control, and minimization of physiologic stress (pain, delirium).

Main Results:

• Many geriatric fracture patients can be safely and effectively managed postoperatively.
• Management involves careful monitoring and control of physiological parameters.
• Chronic cardiovascular therapies may need to be omitted or reduced temporarily.

Conclusions:

• Effective management of postoperative cardiovascular complications in geriatric fracture patients is achievable.
• Guidelines can be developed from existing observational data and geriatric care principles.
• Temporary modification or omission of chronic cardiovascular medications is often necessary until stability is achieved.