RT Book, Section
A1 M. Suskind, Anne
A1 Finlayson, Emily
A2 Brunicardi, F. Charles
A2 Andersen, Dana K.
A2 Billiar, Timothy R.
A2 Dunn, David L.
A2 Kao, Lillian S.
A2 Hunter, John G.
A2 Matthews, Jeffrey B.
A2 Pollock, Raphael E.
SR Print(0)
ID 1164321335
T1 Surgical Considerations in Older Adults
T2 Schwartz's Principles of Surgery, 11e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259835353
LK accesssurgery.mhmedical.com/content.aspx?aid=1164321335
RD 2024/04/20
AB Key  Points  Frailty,  dementia,  and  functional  impairment  are  significant  contributors  to  morbidity  and  mortality  after  surgery.  Assessment  of  these  risk  factors  is  essential  in  an  older  population.  Geriatric  perioperative  pathways  are  effective  in  preventing  delirium,  a  morbid  and  costly  postoperative  complication  that  is  associated  with  cognitive  decline.  Population-based  data  demonstrate  that  mortality  after  emergency  surgery  and  high-risk  cancer  surgery  is  substantially  higher  in  older  adults  that  in  a  younger  population.  Impaired  cardiac  function  is  responsible  for  more  than  half  of  the  postoperative  deaths  in  older  adult  patients,  so  careful  attention  must  be  paid  to  intravascular  volume  status  in  the  perioperative  period.  Many  frail  elders  experience  significant  and  sustained  functional  decline  after  surgery.  Older  adults  with  acute  abdominal  pathology—appendicitis,  cholecystitis—often  do  not  have  fever,  elevated  white  blood  cell  count,  or  physical  findings  of  peritonitis.