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The older surgical patient – to operate or not? A state of the art review
Author(s) -
Santhirapala R.,
Partridge J.,
MacEwen C. J.
Publication year - 2020
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.14910
Subject(s) - medicine , multidisciplinary approach , identification (biology) , task (project management) , constraint (computer aided design) , sustainability , patient care , care pathway , medical emergency , nursing , health care , mechanical engineering , ecology , social science , botany , management , sociology , engineering , economics , biology , economic growth
Summary The increasing age and subsequent medical complexity of patients presenting for surgery grants the opportunity to examine the processes and delivery of peri‐operative care. There is a need to redesign peri‐operative pathways allowing room for shared decision making and personalised, evidence‐based care. In times of financial constraint, this is no easy task. However, neglecting to transform services now may lead to challenges in the sustainability of the provision of peri‐operative care in the long‐term. Challenges in redesigning peri‐operative care pathways include identification and optimisation of those at highest peri‐operative risk to inform the difficult conversations surrounding the appropriateness of surgery. The moral burden of these conversations on patient and professionals alike is increasingly recognised and managing this issue requires innovative models of collaborative, multidisciplinary and interprofessional working. To operate or not can be a challenging question to answer with a number of different perspectives to consider; not least that of the patient.