Considerations for Geriatric Patients Undergoing Colorectal Surgery

Abstract

Key Concepts• The geriatric population is diverse, with varying levels of health status including physiologic reserve and cognitive function. As such, chronological age is a poor marker of functional, physical, and cognitive decline in the elderly.• Fit elderly patients, those without signifi cant comorbidities or cognitive decline, can be managed similar to that of younger patients. Frail patients are associated with higher morbidity and mortality in both elective and emergent operations.• Elderly patients undergoing emergent procedures are at high risk (17-31 %) for post-operative mortality.• Minimally invasive surgery is safe and appropriate in the elderly population, allowing them to benefi t from decreased post-operative morbidity, faster return of bowel function, decreased length of stay, and less pain.• While some assessment models identify age as an independent risk factor for adverse outcomes, a focus on chronologic age substantially limits effective management of the geriatric patient.• Frailty is used to represent a global limited reserve in the elder population. As such, abnormalities in frailty domains are a potentially useful tool for predicting poor outcomes.