Abstract
Qualification of elderly patients for surgical treatment
Given the progress in medicine, including the extension of life, the number of elderly patients will significantly increase in the coming years. This group of patients is highly heterogeneous in terms of comorbidities and physical reserve. Therefore, an optimal and tailored treatment plan is needed, and the preoperative evaluation must include a geriatric assessment (GA) and individualised treatment goals. The GA helps to determine the primary status of an elderly patient, to diagnose the frailty syndrome and to identify previously unrecognised health problems, which allows “optimising” the patient before surgery. The role of the frailty screening tests needs to be studied in more detail. Surgeons must also be aware that surgery is one of the most important factors which may cause disability in elderly patients. In this age group it is more important to be independent than to prolong life. This is particularly true for patients with the frailty syndrome characterised by reduced physiological reserves due to cumulative deficits in several physiological systems, which results in diminished resistance to stressors. As a result, it is of particular importance to individualize the selection of surgical techniques in this group of elderly patients. Currently, choosing a treatment option based on the principles of evidence-based medicine is very difficult in this age group. On the one hand this is due to the low quality of medical publications, and on the other, due to the absence of scientific evidence in many areas. Fortunately, the situation continues to improve.
Piśmiennictwo
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