Perioperative assessment and management of the elderly.

ABSTRACT

Around half of people aged 65 years and above will undergo surgery due to various indications. Several common types of surgery in the elderly are cataract extraction, joint replacement, cholecystectomy, and revascularization procedures. Elderly patients planned for surgery are at risk of having substandard or even terrible outcome due to decreased ability to maintain or recover physiologic homeostasis during surgery. Thorough preoperative assessment is important for the elderly. Preoperative assessment should be stressed on identification of risk factors or bad predictors after the surgery. Common comorbidities in the elderly need comprehensive assessment. Special attention should be given for postoperative management in the elderly. The elderly might need longer time to recover compared to young patients, and management programs might be needed such as sub acute management, rehabilitation unit, or home-care treatment. In general the postoperative treatments consists of the use of analgesic agents, early mobilization, proper use of urine catheter, prevention and management of delirium, and use of anticoagulants.