Abstract
Risk stratification takes an extra level of importance in the context of geriatric surgery. Risk stratification is not only essential for predicting for perioperative morbidity and mortality, but equally important is to predict for return to baseline function. As such, successful surgery is predicated not only on survival but the ability of the patient to return to their desired level of function and independence. This chapter discusses both the traditional risk scoring systems as well as specific geriatric tools and includes a discussion on the concept of frailty.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Saklad M (1941) Grading of Patients for Surgical Parodures. Anesthesioloygy 2(3);272–280
Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383
Copeland GP, Jones D, Walters M (1991) POSSUM: a scoring system for surgical audit. Br J Surg 78(3):355–360
Crome P, Lally F (2011) Frailty: joining the giants. Can Med Assoc J 183(8):889–890
Detsky AS, Abrams HB, Forbath N, Scott JG, Hilliard JR (1986a) Cardiac assessment for patients undergoing non cardiac surgery: a multifactorial clinical risk index. Arch Intern Med 146:2131–2134
Detsky A, Abrams HB, McLaughlin JR, Drucker DJ, Sasson Z, Johnston N, Scott JG, Forbath N, Hilliard JR (1986b) Predicting cardiac complications in patients undergoing non-cardiac surgery. J Gen Intern Med 1(4):211–219
Fleisher LA et al (2007) ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 50:e159–e242
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J et al (2001) Frailty in older adults: evidence for a pheno- type. J Gerontol A Biol Sci Med Sci 56(3):M146–M156
Goldman L, Caldera DL, Nussbaum SR, Southwick FS, Krogstad D, Murray B, Burke DS, O’Malley TA, Goroll AH, Caplan CH, Nolan J, Carabello B, Slatter EE (1977) Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med 297(16):845–850
Issacs B (1997) The challenge of geriatric medicine. Oxford University Press, Oxford
Makary MA, Segev DL, Pronovost PJ, Syin D, Bandeen-Roche K, Patel P, Takenaga R, Devgan L, Holzmueller CG, Tian J, Fried P (2010) Frailty as a predictor of surgical outcomes of older patients. J Am Coll Surg 39:412–423
Prytherch DR, Whitely MS, Weaver PC, Prout WG, Powell SJ (1998) POSSUM and Portsmouth POSSUM for predicting mortality. Br J Surg 85(9):1217–1220
Rockwood K, Song X, MacKnight C et al (2005) A global clinical measure of fitness and frailty in elderly people. Can Med Assoc J 173:489–495
Tan KY, Kawamura YJ, Tokomitsu A, Tang T (2011) Assessment for frailty is useful for predicting morbidity in elderly patients undergoing colorectal cancer resection whose comorbidities are already optimized. Am J Surg [Epub ahead of print]
Tekkis PP, Prytherch DR, Kocher HM, Senapati A, Poloniecki JD, Stamatakis JD, Windsor AC (2004) Development of a dedicated risk-adjustment scoring system for colorectal surgery (colorectal POSSUM). Br J Surg 91(9):1174–1182
Tran BLP, du Montcel ST, Duron JJ, Levard H, Suc B, Descottes B, Desrousseaux B, Hay JM (2010) Elderly POSSUM, a dedicated score for prediction of mortality and morbidity after major colorectal surgery in older patients. Br J Surg 97(3):296–403
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Woo, E.CH., Tan, KY. (2013). Risk Stratification for Elderly Surgery. In: Tan, KY. (eds) Colorectal Cancer in the Elderly. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-29883-7_3
Download citation
DOI: https://doi.org/10.1007/978-3-642-29883-7_3
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-29882-0
Online ISBN: 978-3-642-29883-7
eBook Packages: MedicineMedicine (R0)