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Preoperative evaluation of the elderly patient
Nowadays, the pre-operative evaluation of older patients is a critical step in the decision-making process. Clinical assessment and care planning should be considered a whole process rather than separate issues. Clinicians should use validated tools for pre-operative risk assessment of older patient...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10540990/ https://www.ncbi.nlm.nih.gov/pubmed/37779566 http://dx.doi.org/10.4103/sja.sja_613_23 |
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author | Schipa, Chiara Luca, Ersilia Ripa, Matteo Sollazzi, Liliana Aceto, Paola |
author_facet | Schipa, Chiara Luca, Ersilia Ripa, Matteo Sollazzi, Liliana Aceto, Paola |
author_sort | Schipa, Chiara |
collection | PubMed |
description | Nowadays, the pre-operative evaluation of older patients is a critical step in the decision-making process. Clinical assessment and care planning should be considered a whole process rather than separate issues. Clinicians should use validated tools for pre-operative risk assessment of older patients to minimize surgery-related morbidity and mortality and enhance care quality. Traditional pre-operative consultation often fails to capture the pathophysiological and functional profiles of older patients. The elderly’s pre-operative evaluation should be focused on determining the patient’s functional reserve and reducing any possible peri-operative risk. Therefore, older adults may benefit from the Comprehensive Geriatric Assessment (CGA) that allows clinicians to evaluate several aspects of elderly life, such as depression and cognitive disorders, social status, multi-morbidity, frailty, geriatric syndromes, nutritional status, and polypharmacy. Despite the recognized challenges in applying the CGA, it may provide a realistic risk assessment for post-operative complications and suggest a tailored peri-operative treatment plan for older adults, including pre-operative optimization strategies. The older adults’ pre-operative examination should not be considered a mere stand-alone, that is, an independent stage of the surgical pathway, but rather a vital step toward a personalized therapeutic approach that may involve professionals from different clinical fields. The aim of this review is to revise the evidence from the literature and highlight the most important items to be implemented in the pre-operative evaluation process in order to identify better all elderly patients’ needs. |
format | Online Article Text |
id | pubmed-10540990 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-105409902023-10-01 Preoperative evaluation of the elderly patient Schipa, Chiara Luca, Ersilia Ripa, Matteo Sollazzi, Liliana Aceto, Paola Saudi J Anaesth Review Article Nowadays, the pre-operative evaluation of older patients is a critical step in the decision-making process. Clinical assessment and care planning should be considered a whole process rather than separate issues. Clinicians should use validated tools for pre-operative risk assessment of older patients to minimize surgery-related morbidity and mortality and enhance care quality. Traditional pre-operative consultation often fails to capture the pathophysiological and functional profiles of older patients. The elderly’s pre-operative evaluation should be focused on determining the patient’s functional reserve and reducing any possible peri-operative risk. Therefore, older adults may benefit from the Comprehensive Geriatric Assessment (CGA) that allows clinicians to evaluate several aspects of elderly life, such as depression and cognitive disorders, social status, multi-morbidity, frailty, geriatric syndromes, nutritional status, and polypharmacy. Despite the recognized challenges in applying the CGA, it may provide a realistic risk assessment for post-operative complications and suggest a tailored peri-operative treatment plan for older adults, including pre-operative optimization strategies. The older adults’ pre-operative examination should not be considered a mere stand-alone, that is, an independent stage of the surgical pathway, but rather a vital step toward a personalized therapeutic approach that may involve professionals from different clinical fields. The aim of this review is to revise the evidence from the literature and highlight the most important items to be implemented in the pre-operative evaluation process in order to identify better all elderly patients’ needs. Wolters Kluwer - Medknow 2023 2023-08-18 /pmc/articles/PMC10540990/ /pubmed/37779566 http://dx.doi.org/10.4103/sja.sja_613_23 Text en Copyright: © 2023 Saudi Journal of Anesthesia https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Review Article Schipa, Chiara Luca, Ersilia Ripa, Matteo Sollazzi, Liliana Aceto, Paola Preoperative evaluation of the elderly patient |
title | Preoperative evaluation of the elderly patient |
title_full | Preoperative evaluation of the elderly patient |
title_fullStr | Preoperative evaluation of the elderly patient |
title_full_unstemmed | Preoperative evaluation of the elderly patient |
title_short | Preoperative evaluation of the elderly patient |
title_sort | preoperative evaluation of the elderly patient |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10540990/ https://www.ncbi.nlm.nih.gov/pubmed/37779566 http://dx.doi.org/10.4103/sja.sja_613_23 |
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