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Perioperative care for older people
Judith S L Partridge1,2, S Ramani Moonesinghe3,4, Nicholas Lees5
1Consultant Geriatrician, Perioperative Medicine for Older People undergoing Surgery (POPS), Department of Ageing and Health, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Age and Ageing
|August 30, 2022
Summary
Comprehensive Geriatric Assessment (CGA) and optimization significantly reduce postoperative medical complications in older surgical patients, proving cost-effective. Implementing CGA requires interdisciplinary collaboration and workforce adaptation for optimal patient care.
Area of Science:
- Geriatric Medicine
- Perioperative Care
- Surgical Outcomes
Background:
- Older adults undergoing surgery face higher rates of postoperative medical complications compared to younger patients.
- Surgical benefits for older individuals include symptom relief and extended longevity, necessitating strategies to mitigate risks.
Purpose of the Study:
- To evaluate the effectiveness and cost-effectiveness of Comprehensive Geriatric Assessment (CGA) and optimization in reducing postoperative complications in older surgical patients.
- To explore implementation challenges and propose solutions for widespread adoption of perioperative CGA services.
Main Methods:
- Systematic risk assessment and modification using Comprehensive Geriatric Assessment (CGA) in the perioperative period.
- Analysis of clinical evidence demonstrating the impact of CGA on postoperative medical complications and cost-effectiveness.
- Consideration of implementation strategies involving stakeholder engagement and workforce development.
Main Results:
- Comprehensive Geriatric Assessment and optimization demonstrably reduce postoperative medical complications in older patients.
- These interventions are cost-effective in both elective and emergency surgical settings.
- Implementation faces challenges including stakeholder coordination, workforce limitations, and methodological fidelity.
Conclusions:
- Comprehensive Geriatric Assessment and optimization are vital for improving surgical outcomes and reducing complications in the elderly population.
- Addressing implementation challenges requires an interdisciplinary, evidence-based approach with innovative workforce utilization.
- Future perioperative care necessitates collaboration, national audit, and shared best practices for patient-centeredness.
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