Careful preoperative assessment and perioperative management can mitigate the significant surgical risks faced by elderly patients, particularly regarding pulmonary and cardiac complications.
May support preoperative optimization in elderly surgical patients; leaves open prospective validation of cardiac and pulmonary risk reduction.
Surgical risk increases with age, primarily from loss of cardiac and pulmonary reserve. Complications are tolerated poorly by the elderly, emphasizing the importance of their prediction and prevention. Surgical risk in this population is significant, but with careful preoperative assessment and perioperative management acceptable morbidity and mortality are possible. This review proposes a general approach to the elderly surgical patient and applies it to the most significant sources of morbidity and mortality: pulmonary and cardiac complications. Risk assessment based on validated tools is utilized, and perioperative management recommendations based on the state of the art are examined. In addition, pulmonary embolism and postoperative confusion are examined separately with the same overall strategy.
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Ergina et al. (1993) studied this question.
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