Cirurgia em pacientes idosos: revisão sistemática da literatura

Abstract

Brazil is going through a period of demographic transition characterized by an increase in life expectancy. Concomitantly, the number of surgeries performing on the elderly has also increased. The present study seeks to understand this process by means of a systematic review on academic databases in the last 10 years. From this analysis, it is shown that there is a need for knowledge of the legal framework and the ethical and bioethical aspects by health professionals to perform humanized care directed to this new patient profile. ResumoCirurgia em pacientes idosos: revisão sistemática da literatura O Brasil passa por um período de transição demográfica caracterizado pelo aumento na expectativa de vida. Concomitantemente, tem crescido o número de cirurgias realizadas em idosos. Este trabalho busca compreender esse processo por meio de revisão sistemática de textos publicados nas bases de dados acadêmicas nos últimos 10 anos. Dezessete documentos compõem o corpus da pesquisa. A partir de sua análise, percebe-se a necessidade, por parte dos profissionais de saúde, de conhecer a legislação e refletir sobre aspectos éticos e bioéticos a fim de humanizar o atendimento ao paciente cirúrgico idoso. Palavras-chave: Bioética. Procedimentos cirúrgicos operatórios. Idoso. Resumen Cirugía en pacientes ancianos: revisión sistemática de la literaturaBrasil pasa por un período de transición demográfica caracterizado por el aumento de la expectativa de vida. Concomitantemente, ha aumentado el número de cirugías realizadas en ancianos. Este trabajo busca comprender dicho proceso por medio de una revisión sistemática de textos publicados en las bases de datos académicas en los últimos 10 años. Diecisiete documentos componen el corpus de la investigación. A partir de su análisis, se percibe la necesidad, por parte de los profesionales de salud, de conocer la legislación y reflexionar sobre los aspectos éticos y bioéticos a fin de humanizar la atención brindada al paciente quirúrgico anciano. Palabras clave: Bioética. Procedimientos quirúrgicos operativos. Anciano.Declaram não haver conflito de interesse.

Elderly patient safety in the hospital environment: an integrative literature review

“…It is estimated that, out of every four surgical patients, one of these patients are people over 65 years old and this has several implications in the surgeries performed aiming at the well-being of this elderly person. 20,21 Studies that address surgical issues for the elderly are essential to increase the effectiveness of patient safety. In Germany, research is being carried out to investigate whether an intersectoral and multimodal intervention with staff training, a hospital environment adapted to the needs of the elderly, guidance for family members and best practices for preventing delirium can reduce the prevalence and cognitive decline of the elderly above 70 years postoperatively.…”

“…22 A study carried out in the Netherlands used a web-based application to help physicians perform a medication review, with a database that includes drug interactions, duplicate drugs, contraindications, dosage and amount to be administered, the STRIP Assistant, which according to study data increases from 58 to 76% of adequate prescriptions and reduces from 24 to 42% of wrong decisions, which generated an improvement in the prescription of the elderly and consequently increased patient safety. 21,23 Therefore, nursing actions for elderly patients in the surgical center are based on immediate preoperative care, intraoperative care, and immediate and immediate postoperative care. Regarding immediate preoperative care, assessment scales can be applied to identify possible risks, the Systematization of Nursing Care (SAEP) to carry out the nursing process and humanized care.…”