Truths and Myths of Postoperative Care for the Elderly

Chapter

Abstract

Elderly patients are high-risk patients. They appear to be exposed more to particular risks compared to younger patients. We discuss what these risks are, how they can be minimized and how routine postoperative care can be adapted to the elderly patient as a series of myths and truths.

Keywords

Elderly Patient Functional Decline Anastomotic Dehiscence Ankle Brachial Pressure Index Early Warning Score 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Basili G, Lorenzetti L, Biondi G et al (2008) Colorectal cancer in the elderly. Is there a role for safe and curative surgery? ANZ J Surg 78:466–470PubMedCrossRefGoogle Scholar
  2. Cavaliere F, Conti G, Costa R et al (2008) Intensive care after elective surgery: a survey on 30-day postoperative mortality and morbidity. Minerva Anestesiol 74:459–468PubMedGoogle Scholar
  3. Chee J, Tan KY (2010) Outcome studies on older patients undergoing surgery are missing the mark. J Am Geriatr Soc 58:2238–2239PubMedCrossRefGoogle Scholar
  4. Christmas C, Makary MA, Burton JR (2006) Medical considerations in older surgical patients. J Am Coll Surg 203:746–751PubMedCrossRefGoogle Scholar
  5. Colorectal cancer collaborative group (2000) Surgery for colorectal cancer in elderly patients: a systematic review. Lancet 356:968–974CrossRefGoogle Scholar
  6. Doyle RL (1999) Assessing and modifying the risk of postoperative pulmonary complications. Chest 115:77–81CrossRefGoogle Scholar
  7. Gouvas N, Tan E, Windsor A et al (2009) Fast-track vs standard care in colorectal surgery: a meta-analysis update. Int J Colorectal Dis 24:1119–1131PubMedCrossRefGoogle Scholar
  8. Halter J, Ouslander J, Tinetti M (2009) Hazzard’s geriatric medicine and gerontology. McGraw-Hill, New YorkGoogle Scholar
  9. Jin L, Inoue N, Sato N et al (2011) Comparison between surgical outcomes of colorectal cancer in younger and elderly patients. World J Gastroenterol 28:1642–1648CrossRefGoogle Scholar
  10. Lobo DN, Bostock KA, Neal KR et al (2002) Effect of salt and water balance on recovery of gastrointestinal function after elective colonic resection: a randomised controlled trial. Lancet 25:1812–1818CrossRefGoogle Scholar
  11. Marusch F, Koch A, Schmidt U et al (2005) The impact of the risk factor “age” on the early postoperative results of surgery for colorectal carcinoma and its significance for perioperative management. World J Surg 29:1013–1022PubMedCrossRefGoogle Scholar
  12. NICE (2010) Venous thromboembolism: reducing the risk. National institute for health and clinical excellence. http://guidance.nice.org.uk/CG92
  13. Pedrazzani C, Cerullo G, De Marco G et al (2009) Impact of age-related comorbidity of colorectal cancer surgery. World J Gastroenterol 15(45):5706–5711PubMedCrossRefGoogle Scholar
  14. Quinn TJ, Mcarthur K, Ellis G et al (2011) Functional assessment in older people. BMJ 343(7821):469–473Google Scholar
  15. Stratton RJ, Hackston A, Longmore D et al (2004) Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the ‘malnutrition universal screening tool’ (‘MUST’) for adults. Br J Nutr 92:799–808PubMedCrossRefGoogle Scholar
  16. Tan E, Tilney H, Thompson M (2007) The United Kingdom National Bowel Cancer Project- epidemiology and surgical risk in the elderly. Eur J Cancer 43:2285–2294PubMedCrossRefGoogle Scholar
  17. Tan KY, Chen CN, Ng C et al (2006) Which octogenarians do poorly after major open abdominal surgery in our Asian population? World J Surg 30:547–552PubMedCrossRefGoogle Scholar
  18. Tan KY, Kawamura Y, Mizokami K et al (2009) Colorectal surgery in octogenarian patients – outcomes and predictions of morbidity. Int J Colorectal Dis 24:185–189PubMedCrossRefGoogle Scholar
  19. Tan KY, Konishi F, Tan L et al (2010) Optimizing the management of elderly colorectal surgery patients. Surg Today 40:999–1010PubMedCrossRefGoogle Scholar
  20. Varadhan KK, Lobo DN et al (2010a) Enhanced recovery after surgery: the future of improving surgical care. Crit Care Clin 26:527–547PubMedCrossRefGoogle Scholar
  21. Varadhan KK, Neal KR, Dejong CH et al (2010b) The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials. Clin Nutr 29:434–440PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Department of SurgeryDerby Colorectal Unit, Royal Derby HospitalDerbyUK

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