Präoperative Vorbereitung und Evaluation: der ältere Patient

Abstract

This includes assessment of frailty and functional status as well as the evaluation of pre-existing cognitive deficits, malnutrition and polypharmacy. Prevention of postoperative cognitive deficits and delirium is an important goal of medical therapy and requires i. a. omission of benzodiazepines, BIS-controlled anaesthesia, focus on patient's comfort and orientation and inclusion of close relatives and confidants in all processes. Considering all this, an elderly patient might require more time than usually given to be well prepared for anaesthesia, surgery and the postoperative course. The altered physiology and the special risk profile of the aged patient demand special attention and time throughout the perioperative phase. With an increasing number of elderly presenting for surgery, it is likely that more age-adapted structures and processes become implemented in our hospitals.

The Impact of COVID-19 on Primary Care General Practice Consultations in a Teaching Hospital in Shanghai, China

“…When attendance at outpatients was stratified by age, the largest fall in attendances was observed among relatively younger patients (<40 years), who may have less critical medical conditions, and/or may be able to cope better for a longer period of time while staying at home without consulting a doctor, whereas the elderly patients are more likely to have more severe preexisting medical conditions and therefore may have to seek medical attention more quickly (35). Additionally, while all patients were encouraged to use telephone or online consultations where possible by the health authorities, to minimize potential exposure to the COVID-19 outbreak (36), younger patients may be more likely to engage with technologydriven consultations, such as video consultations, compared to older patients (37).…”

Improving Treatment of Elderly Patients by Interprofessional Education in a Quality Network of Geriatric Medicine: Protocol for Evaluating an Educational Initiative

“…A check list is used to record whether any screenings and assessments, which are recommended for elderly medical care [27], were conducted during inpatient treatment. By using the screening instruments, important diagnostic information for the treatment can be gathered, for example, regarding the general level of functioning, the nutritional state, or the risk of delirium of the patient [28], as these aspects are considered to be of high relevance for an optimal outcome especially after surgery [29,19].…”

“…To assess the outcome, a checklist is used to record whether certain screenings and assessments that are recommended for elderly medical care [26] were conducted during inpatient treatment. By using these instruments, significant diagnostic information for the treatment can be gathered, for example, regarding the general level of functioning, the nutritional state, or the risk of delirium of the patient [27]. Furthermore, it is analyzed whether the social services were involved in the preparations for dismissal and/or family members were informed about current medication.…”

Improvement of perioperative care of the elderly patient (PeriAge): protocol of a controlled interventional feasibility study

“…In Germany, every second inpatient surgical procedure is performed on patients aged 65 years and above 1. This cohort has an elevated risk to suffer from a range of postoperative complications (POCs) 2–6. These include postoperative delirium (POD), pulmonary infection, cardiovascular events and an overall higher rate of postoperative morbidity, consequentially extended hospitalisations, and mortality, but also long-term general decline of health, cognition, functional status and quality of life after surgery 7–11.…”