Show Summary Details
Page of

Pre-operative assessment and preparation of elderly patients undergoing major surgery 

Pre-operative assessment and preparation of elderly patients undergoing major surgery
Pre-operative assessment and preparation of elderly patients undergoing major surgery

Chris Dodds

, Chandra M. Kumar

, and Frédérique Servin

Page of

PRINTED FROM OXFORD MEDICINE ONLINE ( © Oxford University Press, 2016. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 20 July 2018

Age as such is not a good predictor of surgical risk.

Physiological age-related changes increase the risks of surgery and anaesthesia.

Co-morbidities increase with age.

Anaesthetic plan for surgery in elderly is a challenge.

Aim of assessment is to identify within the composite elderly patient what integrated responses are critically reduced, or have failed, and then to systematically review individual organ systems for functional reserve.

Incidence of ischaemic heart disease and valve disease increases with age and is associated with increased morbidity and mortality.

Chest disease is common in the elderly, and pulmonary complications are more common in the post-operative period.

Hepatic insufficiency usually results in a poor surgical outcome.

Renal insufficiency associated with uraemia increases risk.

Presence of interval delirium or confusion indicates a very high risk of post-operative cognitive impairment and general anaesthetic or sedation should be avoided.

Before emergency surgery, there may not be time for complete evaluation and correction of risk factors.

Life saving treatment can proceed without consent.

Advance directives before surgery should be documented, and the name of the patient’s surrogate should be recorded.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.