Department of Medicine, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, USA.
Division of Geriatrics, Duke University School of Medicine, DUMC Box 3003, Durham, NC 27710, USA.
Clin Geriatr Med. 2018 Feb;34(1):95-105. doi: 10.1016/j.cger.2017.08.004. Epub 2017 Oct 18.
Older adults undergoing elective surgical procedures suffer higher rates of morbidity and mortality than younger patients. A geriatric-focused preoperative evaluation can identify risk factors for complications and opportunities for health optimization and care coordination. Key components of a geriatric preoperative evaluation include (1) assessments of function, mobility, cognition, and mental health; (2) reviews of medical conditions and medications; and (3) discussion of risks, preferences, and goals of care. A geriatric-focused, team-based approach can improve surgical outcomes and patient experience.
接受择期手术的老年人比年轻患者遭受更高的发病率和死亡率。以老年为重点的术前评估可以确定并发症的风险因素以及促进健康优化和护理协调的机会。老年术前评估的关键组成部分包括:(1)功能、移动性、认知和心理健康评估;(2)对医疗条件和药物的审查;以及(3)讨论风险、偏好和护理目标。以老年为重点、团队合作的方法可以改善手术结果和患者体验。