Perioperative Geriatric Medicine, University of San Marino, Contrada Omerelli, 20, 47890, San Marino, San Marino.
Aging Clin Exp Res. 2018 Mar;30(3):229-235. doi: 10.1007/s40520-018-0896-y. Epub 2018 Feb 14.
Universally recognized goals of preoperative anesthesia assessment are the evaluation of patient's health status to define the entity of the surgical risk, and the anticipation of possible complications while optimizing and planning preventive strategies. Data obtained by Comprehensive Geriatric Assessment (CGA) and frailty evaluation are of extreme usefulness in surgical risk evaluation in older patients and in the decision about surgery. It is from the team-based discussion of such results that the most appropriate treatment can be individuated, surgery invasiveness and duration critically analyzed and if needed modified, and the best perioperative strategy carefully tailored. These data should thus be used as reference points not only in preoperative assessment but also in planning the perioperative course, from pre-habilitation to adequate intraoperative management to complications prevention and care continuity after discharge. It is from such a far-seeing approach that issues emerged from preoperative evaluation can really contribute to decision-making about surgery in the elderly.
术前麻醉评估被普遍认可的目标是评估患者的健康状况，以确定手术风险的程度，并预测可能的并发症，同时优化和规划预防策略。通过综合老年评估（CGA）和虚弱评估获得的数据对于评估老年患者的手术风险和决定手术具有极其重要的作用。正是基于对这些结果的团队讨论，才能确定最合适的治疗方法，对手术的侵袭性和持续时间进行严格的分析，并在必要时进行修改，并精心制定最佳的围手术期策略。因此，这些数据不仅应作为术前评估的参考点，而且还应作为围手术期计划的参考点，从术前康复到术中适当管理，再到预防并发症和出院后的护理连续性。正是从这种远见卓识的方法中，术前评估中出现的问题才能真正有助于老年患者手术决策。
