Better approach to optimize perioperative care for high risk older patients undergoing non cardiac surgeries

Mayura Thilanka Iddagoda, Athula Karunanayaka

Abstract

Background
As the population is aging, an associated rise in co-morbidities augment perioperative mortality and morbidity. Evidence is emerging to improve perioperative care for high-risk patients in view of better postoperative outcomes.

Aims
While there are number of international guidelines describing preoperative evaluation of such patients, a comprehensive review of a high-risk older patient’s journey through non-cardiac surgery is lacking in the literature. The aim of this review is to recapitulate current evidence for management approaches of high-risk patients undergoing non-cardiac surgeries.

Methods
In this review, literature search was conducted through East Metropolitan Health library service for studies and guidelines published on high risk older patients undergoing non cardiac surgeries. Priority was given to the evidence on preoperative risk stratification, investigation and management of chronic medical conditions and postoperative care.

Conclusion
The available evidence should be used to optimize perioperative outcomes of high and intermediate risk older patients undergoing non-cardiac surgeries.
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