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Basic Preoperative Evaluation and Preoperative Management of the Older Patient

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Geriatric Anesthesiology

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Abstract

The US population is aging, and older individuals undergo surgery four times more often than the rest of the adult population. It is important for the perioperative physician to understand the physiology of aging and the consequence on perioperative outcomes. This chapter reviews preoperative evaluation for the older patient awaiting surgery and summarizes the current literature to determine the best methods of preoperative optimization to ensure improved perioperative outcomes. Despite being associated with more comorbid conditions, most older patients do well after surgery. Focus on preoperative evaluation is an important part of the perioperative care of this growing segment of the population and is the emphasis of this chapter.

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Abbreviations

ACC/AHA:

American College of Cardiology/American Heart Association

AKI:

Acute kidney injury

ASA:

American Society of Anesthesiologists

AT:

Anaerobic threshold

BMI:

Body mass index

CKD:

Chronic kidney disease

COPD:

Chronic obstructive pulmonary disease

CPET:

Cardiopulmonary exercise testing

CXR:

Chest X-ray

ECG:

Electrocardiogram

GFR:

Glomerular filtration rate

IMT:

Inspiratory muscle training

MACE:

Major adverse cardiac event

MET:

Metabolic equivalent

NICE:

National Institute for Health and Care Excellence

NRS:

Nutritional Risk Screening

NSQIP:

National Surgical Quality Improvement Program

POCD:

Postoperative cognitive decline

RCRI:

Revised cardiac risk index

VAS:

Visual analog scale

VE/CO2 :

Ventilatory equivalents for carbon dioxide

VE/VO2 :

Ventilatory equivalents for oxygen

VO2 :

Oxygen consumption

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  1. Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA

    Linda Liu & Jacqueline M. Leung

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  1. Linda Liu
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  1. Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina, USA

    J. G. Reves

  2. Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA

    Sheila Ryan Barnett

  3. Department of Anesthesia and Perioperative Medicine, Department of Anesthesiology, Medical University of South Carolina, Charleston, South Carolina, USA

    Julie R. McSwain

  4. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA

    G. Alec Rooke

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Liu, L., Leung, J.M. (2018). Basic Preoperative Evaluation and Preoperative Management of the Older Patient. In: Reves, J., Barnett, S., McSwain, J., Rooke, G. (eds) Geriatric Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-66878-9_4

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  • DOI: https://doi.org/10.1007/978-3-319-66878-9_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-66877-2

  • Online ISBN: 978-3-319-66878-9

  • eBook Packages: MedicineMedicine (R0)

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