Preoperative Assessment and Perioperative Care

  • Peter Pompei


The ever-increasing number of elderly patients being operated on is due to the expanding elderly population and to important advances in surgical and anesthetic techniques in the second half of this century. As our population ages, there are increasing numbers of individuals who have accumulated chronic diseases requiring surgical intervention, such as cataracts, prostatic hypertrophy, colorectal cancer, and peripheral vascular disease.1 Falls and osteoporosis predispose elderly persons to fractures of the femoral neck, which often require surgical repair. The introduction of neuroleptic anesthesia, effective prophylaxis against deep venous thrombosis, and sophisticated perioperative monitoring technology have contributed to lower surgical mortality for elderly patients.2 In a retrospective study of over 17,000 operations, the surgical mortality rate declined from 3.6% in 1964 to 1.8% in 1974, while the mean age of patients and the percentage who were 70 years of age or older remained constant.2 It has been estimated that about half the people who reach 60 or 70 years of age will require an operation before they die.3 The lowered risk of operative mortality has encouraged physicians and patients to consider surgical therapy more readily.


Cardiac Complication Noncardiac Surgery Cardiac Risk Index Amoxicillin Trihydrate Vancomycin Hydrochloride 
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© Springer Science+Business Media New York 1990

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  • Peter Pompei

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