The article is the result of the first stage of the study devoted to the analysis of the work of accreditation and simulation centers during the period of passing the primary specialized accreditation. The technical issues of the functioning of such centers, as well as the need to develop new methods of interaction between the accredited and the personnel of the simulation centers, were considered.

Age-related changes in the body and concomitant somatic pathology can have a significant impact on the body adaptation processes to operational stress, which is associated with the development of adverse events in the intraoperative period, postoperative complications and long-term prognosis. Both the initial state of the body and the severity of changes in metabolism in response to operational stress, as well as the involvement degree of the body functional reserves, are important. Traditionally used methods for risk stratification, based on a patient’s survey or assessment of his daily activity, do not always provide a comprehensive, objective assessment of the body functional capabilities, especially in patients of older age groups. The prognostic value of cardiopulmonary exercise testing for determining the indications and the risk of complications in various types of surgical interventions has been proved. Based on the results of preoperative cardiopulmonary exercise testing, it is possible to make a more complete, comprehensive assessment of the patient’s body functional status, which is especially important for polymorbid patients. However, at present, there are no clearly defined normative limits for the indicators of cardiopulmonary exercise testing for patients of older age groups, which determines the future prospects for studying the use of this method for patients over 60 years of age with various pathological conditions. KEYWORDS: aging, operational stress, adaptation, functional reserve, prognosis, age-related features, cardiopulmonary exercise testing. FOR CITATION: Trotsyuk D.V., Medvedev D.S., Zaripova Z.A., Chikov A.E. Risks of perioperative complications in patients of older age groups: causes, mechanisms and prognostic possibilities. Russian Medical Inquiry. 2021;5(3):150–155. DOI: 10.32364/2587-6821-2021-5-3-150-155.

No abstract

The OBJECTIVE was to identify prognostic factors of long-term air leak after lobectomies based on the analysis of the main preoperative and surgical clinical and functional indicators.METHODS AND MATERIALS. A retrospective study included 71 patients who underwent lung resection in the volume of lobectomy for lung cancer. The patients were divided into three groups - group 1 (n=42, 59 %) - air leak through the drains stopped within a day after surgery; group 2 (n=10, 14 %) - the duration of air leak from the pleural cavity from 1 to 5 days; group 3 (n=19, 27 %) the duration of air leak more than 5 days after surgery.RESULTS. The average values of the main clinical, surgical and functional indicators, such as the frequency of concomitant COPD, the severity of its course, smoking status, access (thoracotomy / thoracoscopy) in the three groups were almost the same. The difference in the average value of DLCO was characterized by the greatest tendency to reliability: the longer the pulmonary air leak was, the lower the values of this indicator turned out to be. Correlation analysis revealed a noticeable feedback between the long-term pulmonary air leak and the preoperative level of FEV1 (r=-0.59), a direct relationship between the level of FEV1 and DLCO (r=0.51), as well as a noticeable feedback between the long-term pulmonary air leak and the level of DLCO (r=-0.61) and a direct moderate relationship between the pulmonary air leak and the time spent on the stair climbing test (r=0.38).CONCLUSIONS. The combination of a low level of FEV1, a low level of DLCO and a long duration of the stair climbing test makes it possible to assess the risk of prolonged pulmonary air leak as significant and take this into account during the surgical intervention.

No abstract