Scandrett Karen G, Zuckerbraun Brian S, Peitzman Andrew B
Department of Geriatric Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Surg Clin North Am. 2015 Feb;95(1):149-72. doi: 10.1016/j.suc.2014.09.014. Epub 2014 Nov 20.
As the population ages, the health care system must to adapt to the needs of the older population. Hospitalization risks are particularly significant in the frail geriatric patients, with costly and morbid consequences. Appropriate preoperative assessment can identify sources of increased risk and enable the surgical team to manage this risk, through "prehabilitation," intraoperative modification, and postoperative care. Geriatric preoperative assessment expands usual risk stratification and careful medication review to include screening for functional disability, cognitive impairment, nutritional deficiency, and frailty. The information gathered can also equip the surgeon to develop a patient-centered and realistic treatment plan.
随着人口老龄化，医疗保健系统必须适应老年人群的需求。在体弱的老年患者中，住院风险尤为显著，会带来高昂的费用和不良后果。适当的术前评估可以识别增加风险的来源，并使手术团队能够通过“术前康复”、术中调整和术后护理来管理这种风险。老年患者术前评估扩展了常规的风险分层和仔细的用药审查，以包括对功能残疾、认知障碍、营养缺乏和体弱的筛查。收集到的信息还可以使外科医生制定以患者为中心且切实可行的治疗计划。
