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Current Anesthesiology Reports
Published in: Current Anesthesiology Reports 4/2019

01-12-2019 | Care | Geriatric Anesthesia (S Akhtar, Section Editor)

Perioperative Acute Care of Older Patients Living with Frailty

Authors: Janny Xue Chen Ke, David B. MacDonald, Daniel I. McIsaac

Published in: Current Anesthesiology Reports | Issue 4/2019

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Abstract

Purpose of Review

Frailty has been independently linked to adverse postoperative outcomes including increased morbidity, mortality, health resource use, and disability. We discuss the data underlying these associations, as well as literature supporting perioperative frailty assessment and perioperative management strategies, with a focus on older people with frailty undergoing elective, non-cardiac surgery.

Recent Findings

Perioperative interventions tested to improve outcomes for older people with frailty are limited; interventions proven to improve outcomes are even more rare. Current evidence-based strategies include exercise therapy, preoperative identification and communication of frailty status, and multidisciplinary geriatric focused care. No specific intraoperative strategy exists to impact outcomes for people with frailty.

Summary

Older people with frailty are vulnerable to adverse outcomes following surgery. However, significant knowledge gaps exist with respect to encouraging routine assessment of frailty and development of effective perioperative interventions. Anesthesiologists are uniquely poised to facilitate the multidisciplinary perioperative care of frail patients. High-quality trials are needed to elucidate patient-centered outcomes, risk prediction, shared decision-making, and individualized perioperative interventions in older patients with frailty.
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Metadata
Title
Perioperative Acute Care of Older Patients Living with Frailty
Authors
Janny Xue Chen Ke
David B. MacDonald
Daniel I. McIsaac
Publication date
01-12-2019
Publisher
Springer US
Keyword
Care
Published in
Current Anesthesiology Reports / Issue 4/2019
Electronic ISSN: 2167-6275
DOI
https://doi.org/10.1007/s40140-019-00355-8

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