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General Management in the Elderly: Preoperative and ICU

  • Alain Corcos
  • Andrew B. PeitzmanEmail author

Abstract

As the population ages, trauma physicians are treating more elderly patients. An understanding and appreciation for the unique aspects of this demographic is essential to maximize outcomes. This chapter will review the physiological changes that occur normally with aging, concentrating on the cardiopulmonary, neurological, and renal systems. We will also discuss the important premorbid conditions that affect resuscitation, treatment plans, disposition, and outcomes; these include comorbidity, medications, nutrition, cognitive status, and functional capacity. We will introduce the concept of frailty in the elderly and its importance for prognosis. Finally, we will present the latest recommendations regarding the approach to the elderly patient who presents with emergency surgical needs with an advanced directive in place.

Keywords

Geriatrics Geriatric trauma Physiology of aging Perioperative geriatric assessment and management Frailty Advanced directives and surgery 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Trauma Services, Division of Multisystem TraumaUPMC Mercy HospitalPittsburghUSA
  2. 2.Department of SurgeryUPMC-PresbyterianPittsburghUSA

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