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Preoperative evaluation of the elderly patient
Chiara Schipa1,2, Ersilia Luca1,2, Matteo Ripa2,3
1Dipartimento di Scienze dell'emergenza, anestesiologiche e della rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome.
Saudi Journal of Anaesthesia
|October 2, 2023
Summary
Pre-operative risk assessment for older patients is crucial. Comprehensive Geriatric Assessment (CGA) helps identify needs and tailor care to reduce surgical risks and improve outcomes.
Area of Science:
- Geriatric Medicine
- Surgical Oncology
- Evidence-Based Practice
Background:
- Pre-operative evaluation of older patients is critical for surgical decision-making and care planning.
- Traditional consultations often miss key pathophysiological and functional aspects of elderly patients.
- Focusing on functional reserve and peri-operative risk reduction is essential for the elderly.
Purpose of the Study:
- To review literature on pre-operative evaluation for older adults.
- To highlight essential components for identifying elderly patients' needs.
- To emphasize a personalized therapeutic approach involving multidisciplinary teams.
Main Methods:
- Literature review of evidence on pre-operative assessment tools for older patients.
- Analysis of components within Comprehensive Geriatric Assessment (CGA).
- Identification of key elements for tailored peri-operative care plans.
Main Results:
- Comprehensive Geriatric Assessment (CGA) evaluates multiple domains: cognition, mood, social factors, comorbidities, frailty, and polypharmacy.
- CGA provides realistic risk assessment for post-operative complications.
- CGA facilitates tailored pre-operative optimization strategies.
Conclusions:
- Pre-operative evaluation for older adults requires a holistic approach beyond traditional consultations.
- Comprehensive Geriatric Assessment (CGA) is vital for personalized risk assessment and peri-operative planning.
- Integrating CGA into the surgical pathway improves care quality and reduces morbidity/mortality.
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