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Outcomes after non-cardiac surgery: Mortality, complications, disability, and rehospitalization

Bruno Amato, Mario Santoro, Giuseppe Giugliano, Giuseppe Servillo, Veronica Di Nardo, Lorenza Di Domenico, Rita Compagna, Raffaele Izzo
  • Bruno Amato
    University of Naples Federico II, Department of Clinical Medicine and Surgery, Italy | bruno.amato@unina.it
  • Mario Santoro
    University of Naples Federico II, Department of Translational Medical Sciences, Italy
  • Giuseppe Giugliano
    University of Naples Federico II, Department of Advanced Biomedical Sciences, Italy
  • Giuseppe Servillo
    University of Naples Federico II, Department of Neuroscience, Italy
  • Veronica Di Nardo
    University of Naples Federico II, Department of Nuclear Physics and Radiation, Italy
  • Lorenza Di Domenico
    University of Naples Federico II, Department of Neuroscience, Italy
  • Rita Compagna
    University of Naples Federico II, Department of Clinical Medicine and Surgery, Italy
  • Raffaele Izzo
    University of Naples Federico II, Department of Clinical Medicine and Surgery, Italy

Abstract

In the last 25 years, the number of patients aged ≥75 years undergoing non-cardiac surgery has greatly increased. In elderly patients, frailty is significantly associated with an increased risk of adverse events, functional decline, procedural complications, prolonged hospitalization, and mortality. The relationship between frailty and increased mortality and morbidity requires an appropriate tool of assessment to accurately quantify the patient’s clinical and perioperative conditions. The preoperative evaluation of elderly patients candidate for non-cardiac surgery should include assessment of frailty, sarcopenia and malnutrition, as these are related to high surgical risk. For colon-rectal surgery as also for gastric cancer surgery, especially early gastric cancer, the introduction of laparoscopy has yielded considerable benefits in terms of short-term postsurgical outcomes, e.g. lower rate of intraprocedural bleeding and reduced length of hospital stay. Despite the progress made in preoperative assessment, surgical procedures and postoperative management, the improvement of outcomes after non-cardiac surgery in elderly patients remains a challenge and calls for future, well-designed clinical studies.

Keywords

Frailty; surgical outcomes; risk assessment; geriatric population.

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Submitted: 2017-05-16 11:21:09
Published: 2017-07-18 14:29:53
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Copyright (c) 2017 Bruno Amato, Mario Santoro, Giuseppe Giugliano, Giuseppe Servillo, Veronica Di Nardo, Lorenza Di Domenico, Rita Compagna, Raffaele Izzo

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