Perioperative Care for Geriatric Patients Undergoing Surgery

Increasing numbers of elderly patients are undergoing an increasing variety of surgical procedures1. The older adult population (greater than65 years) is growing at a rapid rate, and a significant percentage of older adults undergo surgical procedures2. There is an age-related decline in physiological reserve, which may be compounded by illness, cognitive decline, frailty and polypharmacy. Compared with younger surgical patients, the elderly are at relatively higher risk of mortality and morbidity after elective and (especially) emergency surgery. Multidisciplinary care improves outcomes for elderly surgical patients. Protocol-driven integrated pathways guide care effectively, but must be individualised to suit each patient. The AAGBI strongly supports an expanded role for senior geriatricians in coordinating peri-operative care for the elderly, with input from senior anaesthetists (consultants/associate specialists) and surgeons. The purpose of this review is the importance of better knowing the status of the elderly, the anaesthesia and surgery effect on these patients, in order to help in the postoperator rehabilitation of the elderly.