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Review
. 2020 Sep;32(9):1647-1673.
doi: 10.1007/s40520-020-01624-x. Epub 2020 Jul 10.

Perioperative Management of Elderly patients (PriME): recommendations from an Italian intersociety consensus

Paola Aceto  1   2 , Raffaele Antonelli Incalzi  3 , Gabriella Bettelli  4 , Michele Carron  5 , Fernando Chiumiento  6 , Antonio Corcione  7 , Antonio Crucitti  1   2 , Stefania Maggi  8 , Marco Montorsi  9 , Maria Caterina Pace  10 , Flavia Petrini  11 , Concezione Tommasino  12 , Marco Trabucchi  13 , Stefano Volpato  14 ; Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI), Società Italiana di Gerontologia e Geriatria (SIGG), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia Geriatrica (SICG) and Associazione Italiana di Psicogeriatria (AIP)
Affiliations
Review

Perioperative Management of Elderly patients (PriME): recommendations from an Italian intersociety consensus

Paola Aceto et al. Aging Clin Exp Res. 2020 Sep.

Erratum in

  • Correction to: Perioperative Management of Elderly patients (PriME): recommendations from an Italian intersociety consensus.
    Aceto P, Antonelli Incalzi R, Bettelli G, Carron M, Chiumiento F, Corcione A, Crucitti A, Maggi S, Montorsi M, Pace MC, Petrini F, Tommasino C, Trabucchi M, Volpato S; Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI), Società Italiana di Gerontologia e Geriatria (SIGG), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia Geriatrica (SICG) and Associazione Italiana di Psicogeriatria (AIP). Aceto P, et al. Aging Clin Exp Res. 2020 Sep;32(9):1907. doi: 10.1007/s40520-020-01701-1. Aging Clin Exp Res. 2020. PMID: 32910423 Free PMC article.

Abstract

Background: Surgical outcomes in geriatric patients may be complicated by factors such as multiple comorbidities, low functional performance, frailty, reduced homeostatic capacity, and cognitive impairment. An integrated multidisciplinary approach to management is, therefore, essential in this population, but at present, the use of such an approach is uncommon. The Perioperative Management of Elderly patients (PriME) project has been established to address this issue.

Aims: To develop evidence-based recommendations for the integrated care of geriatric surgical patients.

Methods: A 14-member Expert Task Force of surgeons, anesthetists, and geriatricians was established to develop evidence-based recommendations for the pre-, intra-, and postoperative care of hospitalized older patients (≥ 65 years) undergoing elective surgery. A modified Delphi approach was used to achieve consensus, and the strength of recommendations and quality of evidence was rated using the U.S. Preventative Services Task Force criteria.

Results: A total of 81 recommendations were proposed, covering preoperative evaluation and care (30 items), intraoperative management (19 items), and postoperative care and discharge (32 items).

Conclusions: These recommendations should facilitate the multidisciplinary management of older surgical patients, integrating the expertise of the surgeon, the anesthetist, the geriatrician, and other specialists and health care professionals (where available) as needed. These roles may vary according to the phase and setting of care and the patient's conditions.

Keywords: Analgesia; Anesthesia; Comprehensive geriatric assessment; Frail older; Older patients; Perioperative care; Surgery.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

References

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