Galazka S S
Department of Family Medicine, School of Medicine, Case Western Reserve University, Cleveland, Ohio 44106.
J Fam Pract. 1988 Dec;27(6):622-32.
Family physicians are often requested to provide preoperative evaluation of elderly patients. Age independently increases the risk of morbidity and mortality in the perioperative period. In addition, the altered physiology of the older patient, in combination with the increased number of disease processes, increases the potential for complications. A comprehensive preoperative assessment includes an evaluation of the patient's present physiological functioning and attempts to detect the presence and status of any disease processes. Evaluation includes a thorough history, physical examination, and laboratory testing. Special considerations in preoperative assessment of the elderly patient include the assessment of nutrition, functional capabilities, and evaluation of the cognitive and emotional status of the patient. Special concerns include prophylaxis for deep vein thrombosis and pulmonary embolus, and antibiotic prophylaxis for endocarditis and for patients with joint prostheses.
家庭医生经常被要求对老年患者进行术前评估。年龄本身会增加围手术期发病和死亡的风险。此外，老年患者生理机能的改变，再加上疾病过程数量的增加，会增加并发症的可能性。全面的术前评估包括对患者当前生理功能的评估，并试图检测任何疾病过程的存在和状况。评估包括详细的病史、体格检查和实验室检查。老年患者术前评估的特殊考虑因素包括营养评估、功能能力评估以及患者认知和情绪状态的评估。特别关注的问题包括深静脉血栓形成和肺栓塞的预防，以及心内膜炎和关节假体患者的抗生素预防。
