ABSTRACT

Perioperative problems in the elderly population

It is estimated that elderly patients account for half of all adults undergoing surgery, however, about 80% of peri- and postoperative complications occur in this age group. There is no significant difference in the percentage of surgical complications reported for young adults and elderly patients. However, such complications pose a significant threat to the elderly population due to limited physiological reserves in this patient group. In addition, related symptoms may be uncharacteristic, which may delay the diagnosis and initiation of appropriate treatment. It should be noted that even a minor complication can have a domino effect and lead to very serious consequences. Therefore, it is recommended to actively check for possible complications during the postoperative period as well as take all possible preventive measures.

The key measures during the preoperative period include an appropriate risk assessment (taking into account results of a Comprehensive Geriatric Assessment, individual treatment goals and life expectancy) as well as pre-rehabilitation prior to elective procedures. Currently, it is impossible to modify the pro- and anti-inflammatory response associated with surgical treatment. Therefore, the risk of related injuries should be limited as much as possible by using minimally invasive surgical methods, minimizing intraoperative blood loss (even if such an approach implies longer operation time), avoiding hypothermia, and building an experienced surgical and anesthesia care team (especially in the case of patients with frailty syndrome).

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