A non-systematic narrative review of available studies to summarize evidence to support best clinical practice in perioperative care of patients 80 years and older has been published in the journal European Geriatric Medicine.
The researchers state that “geriatric-specific problems (frailty, cognitive decline, malnutrition, sarcopenia, comorbidities) should be assessed and addressed in preoperative assessment” and that “perioperative care should take into consideration comorbidities and delirium risk,” adding that “rehabilitation and post-discharge care are pivotal due to high risk of functional decline.”
The preoperative assessment, state the researchers, “should take into consideration comorbidities and cardiac risk as well as geriatric syndromes, including cognitive decline, sarcopenia, frailty, and malnutrition. Identification of geriatric syndromes should prompt intervention or involvement of an interdisciplinary team. In the perioperative period, caution regarding medication is advised due to frequent polypharmacy and altered pharmacodynamics of drugs. Perioperative delirium should be prevented and adequately managed. Due to a significant risk of postoperative functional decline, rehabilitation and coordinated post-discharge care play a pivotal role in the postoperative period.”
They conclude that despite the increase of “high-quality evidence in the field, an individualized approach and involvement of an interdisciplinary team are frequently required in this group of patients.”
