Mistry Preeya K, Gaunay Geoffrey S, Hoenig David M
The Smith Institute for Urology, Northwell Health-Hofstra University School of Medicine, New Hyde Park, NY, USA.
Asian J Urol. 2017 Jan;4(1):44-49. doi: 10.1016/j.ajur.2016.07.001. Epub 2016 Aug 18.
As the number of Americans aged 65 years and older continues to rise, there is projected to be a corresponding increase in demand for major surgeries within this population. Consequently, it is important to utilize accurate preoperative risk stratification techniques that are applicable to elderly individuals. Currently, commonly used preoperative risk assessments are subjective and often do not account for elderly-specific syndromes that may pose a hazard for geriatric patients if not addressed. Failure to accurately risk-stratify these patients may increase the risk of postoperative complications, morbidity, and mortality. Therefore, we aimed to identify and discuss the more objective and better-validated measurements indicative of poor surgical outcomes in the elderly with special focus on frailty, patient optimization, functional status, and cognitive ability.
随着65岁及以上美国人口数量持续增长,预计该人群对大手术的需求也会相应增加。因此,运用适用于老年人的准确术前风险分层技术很重要。目前,常用的术前风险评估具有主观性,且往往未考虑到老年特异性综合征,若不加以应对,这些综合征可能对老年患者构成危险。未能对这些患者进行准确的风险分层可能会增加术后并发症、发病率和死亡率的风险。因此,我们旨在识别并讨论更客观且验证性更好的指标,这些指标表明老年人手术预后不良,特别关注衰弱、患者优化、功能状态和认知能力。