Preventive measures in the elderly surgical patient.

The death rates associated with all forms of surgical illness increase consistently with age but appear more closely related to physiologic and medical status than to age per se. Changes in physiologic function with advancing age are marked by a decreased sensitivity to perturbations and a decreased efficiency of homeostatic mechanisms. Recognition of the heterogeneity of the aging process is fundamental to appropriate decision-making in the elderly surgical patient and thus to avoiding complications. Careful preoperative assessment of medical problems and potential age-related changes in physiologic function, preoperative orientation and teaching, consideration of deep venous thrombosis prophylaxis, effective pain management, early postoperative mobilization and careful attention to drug and fluid and electrolyte therapy are essential in management of the elderly surgical patient.