Key result
Perioperative comprehensive geriatric assessment benefits older surgical patients but needs further evaluation in frail populations.
Why the study?
Older adults undergoing surgery face high perioperative morbidity and mortality, with age-related physiological changes and geriatric syndromes such as frailty driving adverse postoperative outcomes.
Does comprehensive geriatric assessment (CGA) and management improve perioperative outcomes in older adults undergoing surgery?
Does comprehensive geriatric assessment (CGA) and management improve perioperative outcomes in older adults undergoing surgery?
Perioperative models of comprehensive geriatric assessment are beneficial for older surgical patients, highlighting the need to bridge the implementation gap in routine care.
Supports perioperative CGA use in older adults; leaves open cost-effectiveness trials in frail subgroups.
Older adults undergoing surgery have high perioperative morbidity and mortality. Age-related physiological changes and prevalence of geriatric syndromes such as frailty increase the risk of adverse postoperative outcomes. Geriatricians utilise comprehensive geriatric assessment (CGA) and management to identify and manage geriatric syndromes, and deliver patient-centred perioperative care. Perioperative models of CGA are established for older patients undergoing hip fracture surgery. Recent trials support the benefits of perioperative models of CGA for non-orthopaedic surgery, and have influenced current care recommendations for older surgical patients. Areas for further action include addressing the implementation gap between recommended evidence-based perioperative care and routine perioperative care, evaluating the clinical and cost-effectiveness of perioperative models of CGA for patients living with frailty, and embedding routine use of patient-reported outcome measures to inform quality improvement.
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Thillainadesan et al. (2021) conducted a review in Older adults undergoing surgery. Comprehensive geriatric assessment (CGA) was evaluated. Perioperative models of comprehensive geriatric assessment are beneficial for older surgical patients, though further evaluation of clinical and cost-effectiveness in frail patients is needed.
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