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The physician’s role in perioperative management of older patients undergoing surgery

Gordon, Adam L.; Evans, Barry J.; Dhesi, Jugdeep

Authors

ADAM GORDON Adam.Gordon@nottingham.ac.uk
Professor of The Care of Older People

Barry J. Evans

Jugdeep Dhesi



Abstract

Life-sustaining and life-improving surgical interventions are increasingly available to older, frailer patients, many of whom have multimorbidity. Physicians can help support perioperative multidisciplinary teams with assessment and preoperative optimisation of physiological reserve, comorbidities and associated geriatric syndromes. Similar structured support can be useful in the postoperative period where older patients are at increased risk of delirium, medical complications, increased functional dependency and where discharge planning can prove more difficult than in younger cohorts. Comprehensive geriatric assessment has been shown to improve outcomes and is now embedded in most UK-based services for traumatic hip fracture. Perioperative comprehensive geriatric assessment has been explored in other surgical disciplines and procedures and, where evaluated, has been associated with improved outcomes. The need to support older patients with frailty undergoing surgery exceeds the capacity of specialist geriatricians. Other groups of healthcare professionals need to nurture the core competencies to support this group perioperatively.

Journal Article Type Article
Publication Date Jul 1, 2017
Journal Clinical Medicine
Print ISSN 1470-2118
Electronic ISSN 1473-4893
Publisher Royal College of Physicians
Peer Reviewed Peer Reviewed
Volume 17
Issue 4
APA6 Citation Gordon, A. L., Evans, B. J., & Dhesi, J. (2017). The physician’s role in perioperative management of older patients undergoing surgery. Clinical Medicine, 17(4), https://doi.org/10.7861/clinmedicine.17-4-357
DOI https://doi.org/10.7861/clinmedicine.17-4-357
Keywords Geriatric medicine; perioperative care; surgery
Publisher URL http://www.clinmed.rcpjournal.org/content/17/4/357.full
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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