Aucoin Sylvie, McIsaac Daniel I
Department of Anesthesiology & Pain Medicine, The Ottawa Hospital, University of Ottawa, Room B311, 1053 Carling Avenue, Ottawa, Ontario K1S 2Z3, Canada.
Department of Anesthesiology & Pain Medicine, The Ottawa Hospital, University of Ottawa, Room B311, 1053 Carling Avenue, Ottawa, Ontario K1S 2Z3, Canada; Ottawa Hospital Research Institute, School of Epidemiology & Public Health, University of Ottawa, Room B311, 1053 Carling Avenue, Ottawa, Ontario K1S 2Z3, Canada.
Anesthesiol Clin. 2019 Sep;37(3):493-505. doi: 10.1016/j.anclin.2019.04.008. Epub 2019 Jun 17.
Older people are the fastest growing segment of the population and over-represented among people requiring emergency general surgery. Independent of comorbid and procedural factors, perioperative risk increases with increasing age. This effect is amplified with frailty or sarcopenia. Multidisciplinary perioperative care aligned with goals of care is most likely to achieve optimal patient and health system outcomes; however, substantial knowledge gaps exist in emergency general surgery for older people. Anesthesiologists are uniquely positioned to address these knowledge gaps, including optimizing goal-directed intraoperative care, appropriate provision of acute postoperative monitoring, and integration of principles of geriatric medicine in perioperative care.
老年人是人口中增长最快的群体，在需要急诊普通外科手术的人群中占比过高。独立于共病和手术因素之外，围手术期风险会随着年龄的增长而增加。这种影响在体弱或肌肉减少症的情况下会被放大。与护理目标相一致的多学科围手术期护理最有可能实现最佳的患者和卫生系统结果；然而，老年急诊普通外科手术存在大量知识空白。麻醉医生在填补这些知识空白方面具有独特的优势，包括优化目标导向的术中护理、适当提供术后急性监测以及将老年医学原则融入围手术期护理。
