Surgical teams should follow 13 key safety strategies to manage the number and severity of underlying medical problems among geriatric patients, according to joint guidelines issued by the American College of Surgeons and the American Geriatrics Society.
The guidelines, published in the October issue of the Journal of the American College of Surgeons, aim at optimizing surgical care for patients 65 years or older a dramatically growing population, notes the ACS who present for surgery with specific and complex problems. Addressed in the guidelines are such issues as cognitive impairment and dementia, cardiac and pulmonary evaluation, fall risk, medication management, pre-op testing, and patient-family and social support systems.
There's no "magic bullet" for improving surgical care for the elderly, says Clifford Y. Ko, MD, FACS, director of the ACS's National Surgical Quality Improvement Program and Research and Optimal Patient Care division. For example, he points out, a surgical team could accurately assess a patient's cognitive functioning, but fall short in gauging how many medications the patient is taking at the time of surgery. For that surgical team, perioperative medication management becomes the biggest concern, says Dr. Ko.
The bottom line: Guiding elderly patients safely through surgery generally requires a team approach, says Dr Ko, adding, "We want everyone on the same page of providing good, quality care."
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