The physician’s role in perioperative management of older patients undergoing surgery

Life-sustaining and life-improving surgical interventions are increasingly available to older, frailer patients, many of whom have multimorbidity. Physicians can help support perioperative multidisciplinary teams with assessment and preoperative optimisation of physiological reserve, comorbidities a...

Full description

Bibliographic Details
Main Authors: Gordon, Adam L., Evans, Barry J., Dhesi, Jugdeep
Format: Article
Published: Royal College of Physicians 2017
Subjects:
Online Access:https://eprints.nottingham.ac.uk/44559/
_version_ 1848796944270360576
author Gordon, Adam L.
Evans, Barry J.
Dhesi, Jugdeep
author_facet Gordon, Adam L.
Evans, Barry J.
Dhesi, Jugdeep
author_sort Gordon, Adam L.
building Nottingham Research Data Repository
collection Online Access
description Life-sustaining and life-improving surgical interventions are increasingly available to older, frailer patients, many of whom have multimorbidity. Physicians can help support perioperative multidisciplinary teams with assessment and preoperative optimisation of physiological reserve, comorbidities and associated geriatric syndromes. Similar structured support can be useful in the postoperative period where older patients are at increased risk of delirium, medical complications, increased functional dependency and where discharge planning can prove more difficult than in younger cohorts. Comprehensive geriatric assessment has been shown to improve outcomes and is now embedded in most UK-based services for traumatic hip fracture. Perioperative comprehensive geriatric assessment has been explored in other surgical disciplines and procedures and, where evaluated, has been associated with improved outcomes. The need to support older patients with frailty undergoing surgery exceeds the capacity of specialist geriatricians. Other groups of healthcare professionals need to nurture the core competencies to support this group perioperatively.
first_indexed 2025-11-14T19:56:01Z
format Article
id nottingham-44559
institution University of Nottingham Malaysia Campus
institution_category Local University
last_indexed 2025-11-14T19:56:01Z
publishDate 2017
publisher Royal College of Physicians
recordtype eprints
repository_type Digital Repository
spelling nottingham-445592020-05-04T18:52:39Z https://eprints.nottingham.ac.uk/44559/ The physician’s role in perioperative management of older patients undergoing surgery Gordon, Adam L. Evans, Barry J. Dhesi, Jugdeep Life-sustaining and life-improving surgical interventions are increasingly available to older, frailer patients, many of whom have multimorbidity. Physicians can help support perioperative multidisciplinary teams with assessment and preoperative optimisation of physiological reserve, comorbidities and associated geriatric syndromes. Similar structured support can be useful in the postoperative period where older patients are at increased risk of delirium, medical complications, increased functional dependency and where discharge planning can prove more difficult than in younger cohorts. Comprehensive geriatric assessment has been shown to improve outcomes and is now embedded in most UK-based services for traumatic hip fracture. Perioperative comprehensive geriatric assessment has been explored in other surgical disciplines and procedures and, where evaluated, has been associated with improved outcomes. The need to support older patients with frailty undergoing surgery exceeds the capacity of specialist geriatricians. Other groups of healthcare professionals need to nurture the core competencies to support this group perioperatively. Royal College of Physicians 2017-07-01 Article PeerReviewed Gordon, Adam L., Evans, Barry J. and Dhesi, Jugdeep (2017) The physician’s role in perioperative management of older patients undergoing surgery. Clinical Medicine, 17 (4). pp. 357-359. ISSN 1473-4893 Geriatric medicine; perioperative care; surgery http://www.clinmed.rcpjournal.org/content/17/4/357.full doi:10.7861/clinmedicine.17-4-357 doi:10.7861/clinmedicine.17-4-357
spellingShingle Geriatric medicine; perioperative care; surgery
Gordon, Adam L.
Evans, Barry J.
Dhesi, Jugdeep
The physician’s role in perioperative management of older patients undergoing surgery
title The physician’s role in perioperative management of older patients undergoing surgery
title_full The physician’s role in perioperative management of older patients undergoing surgery
title_fullStr The physician’s role in perioperative management of older patients undergoing surgery
title_full_unstemmed The physician’s role in perioperative management of older patients undergoing surgery
title_short The physician’s role in perioperative management of older patients undergoing surgery
title_sort physician’s role in perioperative management of older patients undergoing surgery
topic Geriatric medicine; perioperative care; surgery
url https://eprints.nottingham.ac.uk/44559/
https://eprints.nottingham.ac.uk/44559/
https://eprints.nottingham.ac.uk/44559/