Perioperative Management of Elderly Patients

Schlitzkus, Lisa L.; Melin, Alyson A.; Johanning, Jason M.; Schenarts, Paul J.

doi:10.1016/j.suc.2014.12.001

Cited by 22 publications

(16 citation statements)

References 208 publications

(227 reference statements)

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“…The number of elderly individuals is expected to double in the next 40 years, creating an increased burden of treatment for aging-related disorders, including cardiovascular disease and cancer (1)(2)(3)(4). Aging of the hematopoietic system is associated with a decline in adaptive immunity (5), an increased incidence of anemia (6), and a predisposition to myeloid neoplasms (7,8).…”

Section: Introductionmentioning

confidence: 99%

Endothelial transplantation rejuvenates aged hematopoietic stem cell function

Poulos¹,

Ramalingam

Gutkin

et al. 2017

Journal of Clinical Investigation

119

105

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Section: Introductionmentioning

confidence: 99%

Endothelial transplantation rejuvenates aged hematopoietic stem cell function

Poulos¹,

Ramalingam

Gutkin

et al. 2017

Journal of Clinical Investigation

119

105

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“…The importance of the subject on the oncogeriatric patient is related to the fact that the elderly population is steadily expanding and continuously rising as shown by demographic studies both in industrialized and developing countries, so by 2050, it is estimated that 16 % of the world's population will be aged over 65 years and that this older age group will outnumber the pediatric population of toddlers younger than 6 years -globally [5] .…”

Section: Definitions -Epidemiologymentioning

confidence: 99%

“…Frail older patients are at the highest risk for postoperative morbidity and mortality, much higher than older patients of the same chronological age but without the vulnerability of this syndrome [12] The full-blown phenotype of frailty includes the following characteristics (Fried and Hopkins frailty index) [5]  Unintentional weight loss  Self reported exhaustion  Weakness (in grip strength)  Slow walking speed  Low physical activity A simple tool to estimate these characteristics is the up and go test which measures the time taken for an old seated patient to rise, walk 3 m, turn around and return to their seat thus identifying high risk patients in ground of frailty [5] .…”

Section: Frailtymentioning

confidence: 99%

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Framing the preoperative assessment of the oncogreriatric patient. The surgeon’s point of view

Papagoras¹,

Kanara²,

Ntouvli³

2017

Adv Emerg Med

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Elderly cancer patients represent a steadily rising population constituting a daily problem for any physician, who is confronted not only with medical questions but also with ethical and social dilemmas. In addition oncogeriatric patients are underrepresented or excluded from trials especially in surgery which results in a gap in practical and evidence based knowledge regarding their preoperative evaluation and treatment. Therefore the authors outline the framework a decision making process for a meaning – and success- full treatment plan has to rely on.

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“…The fastest growing segment of the population in the United States are individuals over 65 years of age [ 1 - 2 ], with projections of a further increment of 16.5% by 2020 [ 1 ]. The increasing number of older adults worldwide represents a challenge to any healthcare system [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Outcomes and Complications of Minimally Invasive Surgery of the Lumbar Spine in the Elderly

Avila

Walter

Baaj

2016

Cureus

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Introduction: Minimally invasive spine (MIS) surgery is gaining popularity in the elderly. With aging population and a strong desire for all patients to remain physically active, this trend will likely continue. Previous studies have reported clinical outcomes in the elderly undergoing MIS surgery; however, most of these studies encompass multiple surgeons at different sites and thus present heterogeneous experiences. In this work, we investigate the clinical outcomes and complications of all lumbar MIS procedures performed in patients over 65 years of age by a single surgeon.Methods: A retrospective analysis of a prospectively maintained database of spine surgeries was performed. Twenty-six patients who underwent 27 procedures were included.Results: Mean age at surgery was 72 years (range 64-86). The mean BMI was 30.2 kg/m2, patients had an average of 5 comorbidities, took 9 medications, and 15% were smokers. The mean symptoms duration was 40.6 months with the numeric rating scale (NRS) and the Oswestry disability index (ODI) prior to surgery of 7.68 and 50% respectively. Six different types of procedures were performed, the most common was the interlaminar decompression and fusion (ILIF) followed by MIS laminectomy, microdiscectomy and MIS lateral fusion (XLIF). 74% of the surgeries were done at a single level. Average blood loss was 43 mL, and the mean length of stay was 1.7 days. There were three complications (11.1%): one urinary tract infection, one pulmonary embolism, and one new, postoperative weakness. At six months follow-up, there was a mean improvement of 27% in ODI, and a 5.6 improvement in NRS (both p<0.05); 90% of patients stated they would have the surgery again.Conclusion: Minimally invasive lumbar spine surgery is both safe and highly effective in the elderly population. Patient selection is of utmost importance. This data will add to the existing literature on the overall safety and effectiveness of these procedures in the elderly population.

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Perioperative Management of Elderly Patients

Cited by 22 publications

References 208 publications

Endothelial transplantation rejuvenates aged hematopoietic stem cell function

Endothelial transplantation rejuvenates aged hematopoietic stem cell function

Framing the preoperative assessment of the oncogreriatric patient. The surgeon’s point of view

Outcomes and Complications of Minimally Invasive Surgery of the Lumbar Spine in the Elderly

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