[Preoperative geriatric assessment in major surgery in the aged]

The objective of this study is to investigate if a comprehensive geriatric assessment is useful for predicting morbimortality, functional impairment and the risk for institutionalization for elderly patients after major surgery. A prospective study was carried out at a tertiary hospital, between April and June 1993, including those elderly surgical inpatients for whom a preoperative assessment of the Geriatric Department was demanded. Beside traditional parameters of surgical risk (ASA clas, Goldman index, respiratory and nutritional risk), other medical, functional and social parameters were evaluated. A perioperative follow-up was made and a new functional evaluation one month after discharge. 49.5% of the patients presented perioperative complications and the mortality rate was 10%. 11% needed residential accommodation after discharge. Traditional surgical risks as well as previous functional capacity were predictors of perioperative morbimortality. But only previous functional capacity and nutritional status predict institutionalization. No predictors of functional impairment were found, with the exception of perioperative complications.