The older surgical patient – to operate or not? A state of the art review

R. Santhirapala (Lead / Corresponding author), J. Partridge, C. J. MacEwen

    Research output: Contribution to journalReview article

    Abstract

    The increasing age and subsequent medical complexity of patients presenting for surgery grants the opportunity to examine the processes and delivery of peri-operative care. There is a need to redesign peri-operative pathways allowing room for shared decision making and personalised, evidence-based care. In times of financial constraint, this is no easy task. However, neglecting to transform services now may lead to challenges in the sustainability of the provision of peri-operative care in the long-term. Challenges in redesigning peri-operative care pathways include identification and optimisation of those at highest peri-operative risk to inform the difficult conversations surrounding the appropriateness of surgery. The moral burden of these conversations on patient and professionals alike is increasingly recognised and managing this issue requires innovative models of collaborative, multidisciplinary and interprofessional working. To operate or not can be a challenging question to answer with a number of different perspectives to consider; not least that of the patient.

    Original languageEnglish
    Pages (from-to)e46-e53
    Number of pages9
    JournalAnaesthesia
    Volume75
    Issue numberS1
    Early online date5 Jan 2020
    DOIs
    Publication statusPublished - Jan 2020

    Keywords

    • frailty
    • peri-operative care
    • peri-operative medicine
    • prehabilitation
    • risk assessment
    • shared decision making
    • Surgical Procedures, Operative
    • Humans
    • Risk
    • Refusal to Treat
    • Clinical Decision-Making/methods
    • Aged, 80 and over
    • Aged

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