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Review
. 2020 Feb;43(2):127-136.
doi: 10.1002/clc.23302. Epub 2019 Dec 11.

Perioperative care of the geriatric patient for noncardiac surgery

Jonathan D Wolfe  1 , Natasha K Wolfe  1 , Michael W Rich  1
Affiliations
Review

Perioperative care of the geriatric patient for noncardiac surgery

Jonathan D Wolfe et al. Clin Cardiol. 2020 Feb.

Abstract

Adults age 65 and over are the fastest growing segment of the population in the United States and around the world. As the size of this population expands, the number of older adults referred for surgical procedures will continue to increase. Due to the physiologic changes of aging and the increased frequency of comorbidities, older adults are at increased risk for adverse outcomes, and perioperative care is inherently more complex than in younger individuals. In this review, we discuss the physiologic changes of aging relevant to the surgical patient, comprehensive preoperative assessment, and postoperative management of common complications in older adults in order to promote optimal clinical outcomes both perioperatively and long-term.

Keywords: frailty; geriatric; postoperative complications; preoperative assessment; surgery.

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Conflict of interest statement

We have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Preoperative Cardiac Risk Assessment Algorithm. MI, myocardial infarction; CHF, congestive heart failure; SVT, supraventricular tachycardia; CHB, complete heart block; AVB, atrioventricular block; AS, aortic stenosis; MS, mitral stenosis; mGrad, mean gradient; AVA, aortic valve area; DOE, dyspnea on exertion; MICA, myocardial infarction or cardiac arrest; NSQIP, National Surgical Quality Improvement Program; ACS, American College of Surgeons; RCRI, revised cardiac risk index; METs, metabolic equivalents. Adapted from Peri‐operative cardiovascular evaluation for noncardiac surgery (2014) ACC/AHA, J Am Coll Cardiol. 2014;64(22):e94
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