Perioperative Management of the Geriatric Trauma Patient

An increasing number of trauma patients are elderly. These patients present unique challenges due to their distinct physiological changes and injury patterns. This article aims to summarize recent literature on perioperative management of geriatric trauma patients for anesthesia providers.

Ageing is a multisystem process which may impair the ability of the older person to physiologically respond to trauma. The addition of frailty may further increase their vulnerability to complications.With regards to operative planning, regional anesthesia has not been shown to reduce the risk of delirium compared to general anesthesia. This has been mostly shown with regards to hip fractures, an injury with a high incidence amongst the elderly. There was no reduction in mortality with accelerated hip fracture repair within 6 h of presentation.

Geriatric patients sustain different injuries and mount more limited physiological responses to trauma than their younger counterparts. Pre-existing frailty amongst the elderly may also contribute to complications in the perioperative period.