Perioperative and Postoperative Medical Assessment

As the population ages, more surgical interventions are being performed on elderly patients. The presence of age-related diseases increases morbidity and mortality; however, surgery should not be denied solely based on age. Instead, a comprehensive preoperative assessment that determines risk and maximizes function should drive decisions to proceed with surgery, even in the oldest old. The role of the consulting geriatric specialist is to assist the surgeon in maximizing preoperative function, minimizing the effect of comorbid diseases and preventing or managing postoperative complications, most commonly cardiac, pulmonary and neurological in origin. Preoperative assessment can help identify patients at high risk of complications so that risk reducing interventions can be instituted. Postoperative problems can be prevented or ameliorated by several multidisciplinary strategies. The aim of this chapter is to guide the geriatric specialist in perioperative assessment and management with the goal of lowering complications and improving outcomes after non-cardiac surgery. © 2012 John Wiley & Sons, Ltd.

Duke Scholars

Author Milta O Little Medicine, Geriatrics