Why the study?
Elderly patients represent a growing surgical case-load with age-related declines in physiological reserve and cognitive function that substantially affect peri-operative outcomes, recovery, and quality of life.
A multidisciplinary approach centered on comprehensive geriatric assessment is essential for optimizing peri-operative outcomes and quality of life in elderly and frail patients.
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May support geriatric assessment in elderly perioperative care; leaves open need for RCTs to confirm outcomes.
With increasing life expectancy and technological advancement, provision of anaesthesia for elderly patients has become a significant part of the overall case-load. These patients are unique, not only because they are older with more propensity for comorbidity but a decline in physiological reserve and cognitive function invariably accompanies ageing; this can substantially impact peri-operative outcome and quality of recovery. Furthermore, it is not only morbidity and mortality that matters; quality of life is also especially relevant in this vulnerable population. Comprehensive geriatric assessment is a patient-centred and multidisciplinary approach to peri-operative care. The assessment of frailty has a central role in the pre-operative evaluation of the elderly. Other essential domains include optimisation of nutritional status, assessment of baseline cognitive function and proper approach to patient counselling and the decision-making process. Anaesthetists should be proactive in multidisciplinary care to achieve better outcomes; they are integral to the process.
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Chan et al. (2019) studied this question.
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