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Perioperative Risikostratifizierung geriatrischer Patienten bei nichtkardialen Eingriffen


Beck, S; Büchi, C; Lauber, P; Grob, D; Meier, C (2014). Perioperative Risikostratifizierung geriatrischer Patienten bei nichtkardialen Eingriffen. Zeitschrift für Gerontologie und Geriatrie, 47(2):90-94.

Abstract

BACKGROUND: Older patients more often suffer perioperative complications than younger people. Especially geriatric patients who require emergency treatment represent a high-risk group. Therefore, perioperative risk assessment supports the treatment team in identifying patients at risk and in defining the treatment plan accordingly. MATERIALS AND METHODS: A thorough medical history and clinical examination are pivotal elements of any risk stratification. The organ-specific risk assessment is primarily used to plan the surgical and anesthesiological procedures. RESULTS: For a comprehensive risk assessment in geriatric patients, the organ-specific risk stratification is insufficient. Assessment instruments that reflect the idiosyncrasies of multidimensional disease in geriatric patients can complement risk stratification. These should include the assessment of multimorbidity, frailty, nutrition, activities of daily living, and cognition. In addition to risk prediction, geriatric assessment has the major advantage of providing both a diagnostic and a planning perspective. This allows the implementation of supporting measures for optimal perioperative care, which is the goal of any risk stratification. Risk scores provide a global assessment, but they have their limitations in predicting individual patient risk.

Abstract

BACKGROUND: Older patients more often suffer perioperative complications than younger people. Especially geriatric patients who require emergency treatment represent a high-risk group. Therefore, perioperative risk assessment supports the treatment team in identifying patients at risk and in defining the treatment plan accordingly. MATERIALS AND METHODS: A thorough medical history and clinical examination are pivotal elements of any risk stratification. The organ-specific risk assessment is primarily used to plan the surgical and anesthesiological procedures. RESULTS: For a comprehensive risk assessment in geriatric patients, the organ-specific risk stratification is insufficient. Assessment instruments that reflect the idiosyncrasies of multidimensional disease in geriatric patients can complement risk stratification. These should include the assessment of multimorbidity, frailty, nutrition, activities of daily living, and cognition. In addition to risk prediction, geriatric assessment has the major advantage of providing both a diagnostic and a planning perspective. This allows the implementation of supporting measures for optimal perioperative care, which is the goal of any risk stratification. Risk scores provide a global assessment, but they have their limitations in predicting individual patient risk.

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Additional indexing

Other titles:Perioperative risk assessment of geriatric patients undergoing noncardiac surgery
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Geriatric Medicine
Dewey Decimal Classification:Unspecified
Date:February 2014
Deposited On:24 Feb 2015 15:25
Last Modified:05 Apr 2016 19:07
Publisher:Springer
ISSN:0948-6704
Publisher DOI:https://doi.org/10.1007/s00391-013-0589-2
PubMed ID:24619039

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