Comprehensive Peri-Operative Risk Assessment and Management of Geriatric Patients

<b>Background:</b> As the population ages, the prevalence of surgical interventions in individuals aged 65+ continues to increase. This poses unique challenges due to the higher incidence of comorbidities, polypharmacy, and frailty in the elderly population, which result in high peri-ope...

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Main Authors: Nikolaos Theodorakis, Maria Nikolaou, Christos Hitas, Dimitrios Anagnostou, Magdalini Kreouzi, Sofia Kalantzi, Aikaterini Spyridaki, Gesthimani Triantafylli, Panagiota Metheniti, Ioannis Papaconstantinou
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Language:English
Published: MDPI AG 2024-09-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/14/19/2153
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author Nikolaos Theodorakis
Maria Nikolaou
Christos Hitas
Dimitrios Anagnostou
Magdalini Kreouzi
Sofia Kalantzi
Aikaterini Spyridaki
Gesthimani Triantafylli
Panagiota Metheniti
Ioannis Papaconstantinou
author_facet Nikolaos Theodorakis
Maria Nikolaou
Christos Hitas
Dimitrios Anagnostou
Magdalini Kreouzi
Sofia Kalantzi
Aikaterini Spyridaki
Gesthimani Triantafylli
Panagiota Metheniti
Ioannis Papaconstantinou
author_sort Nikolaos Theodorakis
collection DOAJ
description <b>Background:</b> As the population ages, the prevalence of surgical interventions in individuals aged 65+ continues to increase. This poses unique challenges due to the higher incidence of comorbidities, polypharmacy, and frailty in the elderly population, which result in high peri-operative risks. Traditional preoperative risk assessment tools often fail to accurately predict post-operative outcomes in the elderly, overlooking the complex interplay of factors that contribute to risk in the elderly. <b>Methods:</b> A literature review was conducted, focusing on the predictive value of CGA for postoperative prognosis and the implementation of perioperative interventions. <b>Results:</b> Evidence shows that CGA is a superior predictive tool compared to traditional models, as it more accurately identifies elderly patients at higher risk of complications such as postoperative delirium, infections, and prolonged hospital stays. CGA includes assessments of frailty, sarcopenia, nutritional status, cognitive function, mental health, and functional status, which are crucial in predicting post-operative outcomes. Studies demonstrate that CGA can also guide personalized perioperative care, including nutritional support, physical training, and mental health interventions, leading to improved surgical outcomes and reduced functional decline. <b>Conclusions:</b> The CGA provides a more holistic approach to perioperative risk assessment in elderly patients, addressing the limitations of traditional tools. CGA can help guide surgical decisions (e.g., curative or palliative) and select the profiles of patients that will benefit from perioperative interventions to improve their prognosis and prevent functional decline.
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spelling doaj-art-87e16b979fa644f5bda64d9c7afb52bf2025-08-20T01:47:42ZengMDPI AGDiagnostics2075-44182024-09-011419215310.3390/diagnostics14192153Comprehensive Peri-Operative Risk Assessment and Management of Geriatric PatientsNikolaos Theodorakis0Maria Nikolaou1Christos Hitas2Dimitrios Anagnostou3Magdalini Kreouzi4Sofia Kalantzi5Aikaterini Spyridaki6Gesthimani Triantafylli7Panagiota Metheniti8Ioannis Papaconstantinou9School of Medicine, National, and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, GreeceDepartment of Cardiology, Sismanogleio-Amalia Fleming General Hospital, 14 25is Martiou Str., 15127 Melissia, GreeceDepartment of Cardiology, Sismanogleio-Amalia Fleming General Hospital, 14 25is Martiou Str., 15127 Melissia, GreeceDepartment of Cardiology, Sismanogleio-Amalia Fleming General Hospital, 14 25is Martiou Str., 15127 Melissia, GreeceGeriatric Outpatient Clinic, Sismanogleio-Amalia Fleming General Hospital, 14 25is Martiou Str., 15127 Melissia, GreeceGeriatric Outpatient Clinic, Sismanogleio-Amalia Fleming General Hospital, 14 25is Martiou Str., 15127 Melissia, GreeceGeriatric Outpatient Clinic, Sismanogleio-Amalia Fleming General Hospital, 14 25is Martiou Str., 15127 Melissia, GreeceGeriatric Outpatient Clinic, Sismanogleio-Amalia Fleming General Hospital, 14 25is Martiou Str., 15127 Melissia, GreeceSecond Department of Surgery, Aretaieion General Hospital, National and Kapodistrian University of Athens, 76 Vasilissis Sofias Ave., 11528 Athens, GreeceSecond Department of Surgery, Aretaieion General Hospital, National and Kapodistrian University of Athens, 76 Vasilissis Sofias Ave., 11528 Athens, Greece<b>Background:</b> As the population ages, the prevalence of surgical interventions in individuals aged 65+ continues to increase. This poses unique challenges due to the higher incidence of comorbidities, polypharmacy, and frailty in the elderly population, which result in high peri-operative risks. Traditional preoperative risk assessment tools often fail to accurately predict post-operative outcomes in the elderly, overlooking the complex interplay of factors that contribute to risk in the elderly. <b>Methods:</b> A literature review was conducted, focusing on the predictive value of CGA for postoperative prognosis and the implementation of perioperative interventions. <b>Results:</b> Evidence shows that CGA is a superior predictive tool compared to traditional models, as it more accurately identifies elderly patients at higher risk of complications such as postoperative delirium, infections, and prolonged hospital stays. CGA includes assessments of frailty, sarcopenia, nutritional status, cognitive function, mental health, and functional status, which are crucial in predicting post-operative outcomes. Studies demonstrate that CGA can also guide personalized perioperative care, including nutritional support, physical training, and mental health interventions, leading to improved surgical outcomes and reduced functional decline. <b>Conclusions:</b> The CGA provides a more holistic approach to perioperative risk assessment in elderly patients, addressing the limitations of traditional tools. CGA can help guide surgical decisions (e.g., curative or palliative) and select the profiles of patients that will benefit from perioperative interventions to improve their prognosis and prevent functional decline.https://www.mdpi.com/2075-4418/14/19/2153comprehensive geriatric assessmentperi-operative risk assessmentrehabilitationprehabilitationnutritionexercise
spellingShingle Nikolaos Theodorakis
Maria Nikolaou
Christos Hitas
Dimitrios Anagnostou
Magdalini Kreouzi
Sofia Kalantzi
Aikaterini Spyridaki
Gesthimani Triantafylli
Panagiota Metheniti
Ioannis Papaconstantinou
Comprehensive Peri-Operative Risk Assessment and Management of Geriatric Patients
Diagnostics
comprehensive geriatric assessment
peri-operative risk assessment
rehabilitation
prehabilitation
nutrition
exercise
title Comprehensive Peri-Operative Risk Assessment and Management of Geriatric Patients
title_full Comprehensive Peri-Operative Risk Assessment and Management of Geriatric Patients
title_fullStr Comprehensive Peri-Operative Risk Assessment and Management of Geriatric Patients
title_full_unstemmed Comprehensive Peri-Operative Risk Assessment and Management of Geriatric Patients
title_short Comprehensive Peri-Operative Risk Assessment and Management of Geriatric Patients
title_sort comprehensive peri operative risk assessment and management of geriatric patients
topic comprehensive geriatric assessment
peri-operative risk assessment
rehabilitation
prehabilitation
nutrition
exercise
url https://www.mdpi.com/2075-4418/14/19/2153
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