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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
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In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
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Related Experiment Video

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Author Spotlight: Assessing Surgical Frailty with Point-of-Care Ultrasound of Quadriceps Muscles
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Emergency surgery in the elderly: challenges and solutions.

Andrew D W Torrance1, Susan L Powell2, Ewen A Griffiths3

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Open Access Emergency Medicine : OAEM
|May 6, 2016
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Outcomes for elderly patients with surgical emergencies are poor due to frailty and delayed care. Improving preoperative assessment and using multidisciplinary teams can enhance outcomes for this vulnerable population.

Keywords:
elderly careemergency surgeryfrailtyrisk assessment

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Area of Science:

  • Geriatric Medicine
  • Surgical Emergencies
  • Patient Outcomes

Background:

  • Elderly patients have poor outcomes in surgical emergencies.
  • Contributing factors include frailty, comorbidities, polypharmacy, delayed diagnosis, and suboptimal treatment.
  • This review addresses challenges in emergency surgical care for the elderly.

Purpose of the Study:

  • To review common emergency surgical presentations in the elderly.
  • To highlight specific challenges in managing these patients.
  • To summarize recommendations for improving care over the past 20 years.

Main Methods:

  • Review of 20 years of reports from medical bodies.
  • Analysis of factors contributing to poor outcomes.
  • Identification of key areas for care improvement.

Main Results:

  • Accurate preoperative assessment is crucial for identifying pathology and age-specific issues.
  • Identifying patients for whom treatment is futile or high-risk is essential.
  • Multidisciplinary teams are vital for managing postoperative complications and age-specific syndromes.

Conclusions:

  • Improving care requires addressing preoperative assessment, patient selection, and multidisciplinary team utilization.
  • Preventing complications is more effective than rescue treatment.
  • Further research is needed to improve emergency surgical care for the elderly.