PERIOPERATIVE CARE OF THE ELDERLY PATIENT

Surgical risk increases with age, primarily from loss of cardiac and p ulmonary reserve. Complications are tolerated poorly by the elderly, e mphasizing the importance of their prediction and prevention. Surgical risk in this population is significant, but with careful preoperative assessment and perioperative management acceptable morbidity and mort ality are possible. This review proposes a general approach to the eld erly surgical patient and applies it to the most significant sources o f morbidity and mortality: pulmonary and cardiac complications. Risk a ssessment based on validated tools is utilized, and perioperative mana gement recommendations based on the state of the art are examined. In addition, pulmonary embolism and postoperative confusion are examined separately with the same overall strategy.