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Pre‐ and Postoperative Management of Elderly Surgical Patients *
Author(s) -
GLENN FRANK
Publication year - 1973
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1973.tb01696.x
Subject(s) - medicine , contraindication , disease , surgical stress , intensive care medicine , surgery , alternative medicine , pathology
Can the aging process be altered to prevent the pathologic changes that impair function? The matter should be put in proper perspective. This involves biologic and other forms of research as well as the therapeutic application of current knowledge. About 40 per cent of elderly patients under general hospital care are admitted for surgical treatment. In 1973, the total is expected to reach 2.5 million. Morbidity and mortality associated with surgery are highest among the elderly. However, with the use of new procedures and stress on the factors involved in proper pre‐ and postoperative care, the risk has been greatly reduced. Age‐over‐65 is no longer a contraindication to surgery. The matter of careful evaluation and treatment is discussed under the following categories: status of the patient, status of the various organs and systems (including the effect of trauma), elective versus emergency operations, and the prognosis, especially in relation to such disorders as biliary‐tract disease, cardiovascular disease, cancer, and degenerative hip disease. Preoperative assessment must be thorough and complete. If the situation is not an emergency, there should be a period of corrective nutrition, activity, supportive medication, and instruction of the patient regarding what he may expect. For selective surgical procedures, the response to those measures determines the type of anesthetic and the extent and nature of the operation. The stress of the surgical procedure should never exceed the patient's tolerance. The immediate postoperative care (recovery room) is extremely important. The objective is to prevent complications. The experience of the surgeon, the cooperation of all involved, and meticulous attention to detail are required in the surgical care of the elderly.