The complexity of risk stratification in older patient candidate to non-cardiac surgery

Submitted: December 1, 2015
Accepted: December 1, 2015
Published: December 1, 2015
Abstract Views: 1236
PDF: 741
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

During the last decades the older patients who are candidates for surgery have grown esponentially due to the increase in life expectancy and the surgery technique improvement. Despite this, the mortality remains high and our ability to predict the surgery outcomes continues to be low in the elderly. The main reason is related to different difficulties; we are unable to differentiate properly the chronological from the biological age, and the current surgery and cardiology risk scores are poorly geriatric-oriented. We must underline how the measure of comorbidity during the preoperative evaluation is often limited to a simple count of comorbid conditions, without a more detailed assessment of their severity. On the other hand different comorbidity scores have been validated in geriatric populations showing a good correlation with prognosis, such as the Index of Coexisting Disease-ICED or the Geriatric Index of Comorbidity-GIC. Our predictive deficiency about the outcomes is linked to poor attention for identifying the frail patients that are already at high risk of disability. Recently, the evaluation of frailty is a key target for geriatric medicine, and geriatricians have developed various methods for measuring this parameter and suggesting the physical performance indexes as a reliable surrogate of frailty. Surrogate frailty measures, such as the “gait speed†or the “Short Physical Performance Battery-SPPB†seem to be the valid tools for evaluating older surgery patients due to their simplicity and short administration time. We think that the future challenge will be their widespread use in this specific clinical setting.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

How to Cite

Baldasseroni, Samuele, Francesco Orso, Alessandra Pratesi, Alice Foschini, Andrea Giosafat Marella, Nadia Bartoli, Ilaria Bracali, et al. 2015. “The Complexity of Risk Stratification in Older Patient Candidate to Non-Cardiac Surgery”. Monaldi Archives for Chest Disease 78 (3). https://doi.org/10.4081/monaldi.2012.118.

Similar Articles

<< < 77 78 79 80 81 82 83 84 85 86 > >> 

You may also start an advanced similarity search for this article.