PortalPublikationenThe Perioperative Care of Older Patients

The Perioperative Care of Older Patients

Standard

The Perioperative Care of Older Patients. / Olotu, Cynthia; Weimann, Arved; Bahrs, Christian; Schwenk, Wolfgang; Scherer, Martin; Kiefmann, Rainer.

in: DTSCH ARZTEBL INT, Jahrgang 116, Nr. 5, 01.02.2019, S. 63-69.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung

Harvard

Olotu, C, Weimann, A, Bahrs, C, Schwenk, W, Scherer, M & Kiefmann, R 2019, 'The Perioperative Care of Older Patients', DTSCH ARZTEBL INT, Jg. 116, Nr. 5, S. 63-69. https://doi.org/10.3238/arztebl.2019.0063

APA

Olotu, C., Weimann, A., Bahrs, C., Schwenk, W., Scherer, M., & Kiefmann, R. (2019). The Perioperative Care of Older Patients. DTSCH ARZTEBL INT, 116(5), 63-69. https://doi.org/10.3238/arztebl.2019.0063

Vancouver

Olotu C, Weimann A, Bahrs C, Schwenk W, Scherer M, Kiefmann R. The Perioperative Care of Older Patients. DTSCH ARZTEBL INT. 2019 Feb 1;116(5):63-69. https://doi.org/10.3238/arztebl.2019.0063

Bibtex

@article{faa9c525ca8b4a2e9b1fc7dc00710486,
title = "The Perioperative Care of Older Patients",
abstract = "BACKGROUND: Elderly patients are a growing and vulnerable group with an elevated perioperative risk. Perioperative treatment pathways that take these patients' special risks and requirements into account are often not implemented in routine clinical practice.METHODS: This review is based on pertinent publications retrieved by a selective search in PubMed, the AWMF guideline database, and the Cochrane database for guidelines from Germany and abroad, meta-analyses, and Cochrane reviews.RESULTS: The care of elderly patients who need surgery calls for an interdisciplinary, interprofessional treatment concept. One component of this concept is preoperative preparation of the patient ({"}prehabilitation{"}), which is best initiated before hospital admission, e.g., correction of deficiency states, optimization of chronic drug treatment, and respiratory training. Another important component consists of pre-, intra-, and postoperative measures to prevent delirium, which can lower the frequency of this complication by 30-50%: these include orientation aids, avoidance of inappropriate drugs for elderly patients, adequate analgesia, early mobilization, short fasting times, and a perioperative nutrition plan. Preexisting cognitive impairment predisposes to postoperative delirium (odds ratios [OR] ranging from 2.5 to 4.5). Frailty is the most important predictor of the postoperative course (OR: 2.6-11). It follows that preoperative assessment of the patient's functional and cognitive status is essential.CONCLUZION: The evidence-based and guideline-consistent care of elderly patients requires not only close interdisciplinary, interprofessional, and cross-sectoral collaboration, but also the restructuring and optimization of habitual procedural pathways in the hospital. Elderly patients' special needs can only be met by a treatment concept in which the entire perioperative phase is considered as a single, coherent process.",
keywords = "Aged, Humans, Perioperative Care",
author = "Cynthia Olotu and Arved Weimann and Christian Bahrs and Wolfgang Schwenk and Martin Scherer and Rainer Kiefmann",
year = "2019",
month = feb,
day = "1",
doi = "10.3238/arztebl.2019.0063",
language = "English",
volume = "116",
pages = "63--69",
journal = "DTSCH ARZTEBL INT",
issn = "1866-0452",
publisher = "Deutscher Arzte-Verlag",
number = "5",

}

RIS

TY - JOUR

T1 - The Perioperative Care of Older Patients

AU - Olotu, Cynthia

AU - Weimann, Arved

AU - Bahrs, Christian

AU - Schwenk, Wolfgang

AU - Scherer, Martin

AU - Kiefmann, Rainer

PY - 2019/2/1

Y1 - 2019/2/1

N2 - BACKGROUND: Elderly patients are a growing and vulnerable group with an elevated perioperative risk. Perioperative treatment pathways that take these patients' special risks and requirements into account are often not implemented in routine clinical practice.METHODS: This review is based on pertinent publications retrieved by a selective search in PubMed, the AWMF guideline database, and the Cochrane database for guidelines from Germany and abroad, meta-analyses, and Cochrane reviews.RESULTS: The care of elderly patients who need surgery calls for an interdisciplinary, interprofessional treatment concept. One component of this concept is preoperative preparation of the patient ("prehabilitation"), which is best initiated before hospital admission, e.g., correction of deficiency states, optimization of chronic drug treatment, and respiratory training. Another important component consists of pre-, intra-, and postoperative measures to prevent delirium, which can lower the frequency of this complication by 30-50%: these include orientation aids, avoidance of inappropriate drugs for elderly patients, adequate analgesia, early mobilization, short fasting times, and a perioperative nutrition plan. Preexisting cognitive impairment predisposes to postoperative delirium (odds ratios [OR] ranging from 2.5 to 4.5). Frailty is the most important predictor of the postoperative course (OR: 2.6-11). It follows that preoperative assessment of the patient's functional and cognitive status is essential.CONCLUZION: The evidence-based and guideline-consistent care of elderly patients requires not only close interdisciplinary, interprofessional, and cross-sectoral collaboration, but also the restructuring and optimization of habitual procedural pathways in the hospital. Elderly patients' special needs can only be met by a treatment concept in which the entire perioperative phase is considered as a single, coherent process.

AB - BACKGROUND: Elderly patients are a growing and vulnerable group with an elevated perioperative risk. Perioperative treatment pathways that take these patients' special risks and requirements into account are often not implemented in routine clinical practice.METHODS: This review is based on pertinent publications retrieved by a selective search in PubMed, the AWMF guideline database, and the Cochrane database for guidelines from Germany and abroad, meta-analyses, and Cochrane reviews.RESULTS: The care of elderly patients who need surgery calls for an interdisciplinary, interprofessional treatment concept. One component of this concept is preoperative preparation of the patient ("prehabilitation"), which is best initiated before hospital admission, e.g., correction of deficiency states, optimization of chronic drug treatment, and respiratory training. Another important component consists of pre-, intra-, and postoperative measures to prevent delirium, which can lower the frequency of this complication by 30-50%: these include orientation aids, avoidance of inappropriate drugs for elderly patients, adequate analgesia, early mobilization, short fasting times, and a perioperative nutrition plan. Preexisting cognitive impairment predisposes to postoperative delirium (odds ratios [OR] ranging from 2.5 to 4.5). Frailty is the most important predictor of the postoperative course (OR: 2.6-11). It follows that preoperative assessment of the patient's functional and cognitive status is essential.CONCLUZION: The evidence-based and guideline-consistent care of elderly patients requires not only close interdisciplinary, interprofessional, and cross-sectoral collaboration, but also the restructuring and optimization of habitual procedural pathways in the hospital. Elderly patients' special needs can only be met by a treatment concept in which the entire perioperative phase is considered as a single, coherent process.

KW - Aged

KW - Humans

KW - Perioperative Care

U2 - 10.3238/arztebl.2019.0063

DO - 10.3238/arztebl.2019.0063

M3 - SCORING: Review article

C2 - 30950385

VL - 116

SP - 63

EP - 69

JO - DTSCH ARZTEBL INT

JF - DTSCH ARZTEBL INT

SN - 1866-0452

IS - 5

ER -