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Geriatrics: Traumatic and Non-traumatic Surgical Emergencies

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Textbook of Emergency General Surgery

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Abstract

Elderly patients represent a rapidly growing segment of the world’s population and often experience traumatic and non-traumatic surgical emergencies, which require prompt management. The physiologic decline associated with aging can be better assessed with tools such as frailty, as appropriate risk assessment and resource utilization in treating geriatric patients. Frailty is an entity distinct from age, and gender, affecting outcomes in both trauma and non-trauma emergency general surgery. Trauma-related emergencies such as traumatic brain injury, blunt thoracic trauma, and intra-abdominal hemorrhage are potentially life-threatening pathologies with significant morbidity and mortality. Special population-specific and disease-specific considerations for management can lead to decreasing morbidity and improving both outcomes and quality of life. Both the diagnosis and the management of non-traumatic surgical emergencies such as hollow viscus perforation, cholecystitis, and acute mesenteric ischemia (AMI) are challenging in the elderly. We advocate prompt and timely diagnosis, and patient-centered definitive surgical management in order to improve outcomes and quality of life.

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Further Reading

  • Joseph B, Pandit V, Zangbar B, et al. Validating trauma-specific frailty index for geriatric trauma patients: a prospective analysis. J Am Coll Surg. 2014;219(1):10–7.

    Article  PubMed  Google Scholar 

  • Latifi R, editor. Surgical decision making in geriatrics. Springer Nature; 2020.

    Google Scholar 

  • Massarweh NN, Legner VJ, Symons RG, et al. Impact of advancing age on abdominal surgical outcomes. Arch Surg. 2009;144:1108–14.

    Article  PubMed  Google Scholar 

  • Narueponjikarul N, Hwabejire J, Kongwibulwut M, et al. No news is good news? Three-year postdischarge mortality of octogenarian and nonagenarian patients following emergency general surgery. J Trauma Acute Care Surg. 2020;89(1):230–7. https://doi.org/10.1097/TA.0000000000002696.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Westchester Medical Center, New York Medical College, School of Medicine, Valhalla, NY, USA

    Kartik Prabhakaran & Rifat Latifi

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  1. Kartik Prabhakaran
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Correspondence to Rifat Latifi .

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  1. General, Emergency and Trauma Surgery Dept., Pisa University Hospital, Pisa, Italy

    Federico Coccolini

  2. General and Emergency Surgery Dept., Bufalini Hospital, Cesena, Italy

    Fausto Catena

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Prabhakaran, K., Latifi, R. (2023). Geriatrics: Traumatic and Non-traumatic Surgical Emergencies. In: Coccolini, F., Catena, F. (eds) Textbook of Emergency General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-22599-4_23

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