Please wait a minute...
Search Asian J Urol Advanced Search
Share 
Asian Journal of Urology, 2017, 4(1): 44-49    
  本期目录 | 过刊浏览 | 高级检索 |
Prediction of surgical complications in the elderly: Can we improve outcomes?
Preeya K. Mistry, Geoffrey S. Gaunay, David M. Hoenig
The Smith Institute for Urology, Northwell Health-Hofstra University School of Medicine, New Hyde Park, NY, USA
Prediction of surgical complications in the elderly: Can we improve outcomes?
Preeya K. Mistry, Geoffrey S. Gaunay, David M. Hoenig
The Smith Institute for Urology, Northwell Health-Hofstra University School of Medicine, New Hyde Park, NY, USA
下载:  PDF (435KB) 
输出:  BibTeX | EndNote (RIS)      
摘要 As the number of Americans aged 65 years and older continues to rise, there is projected to be a corresponding increase in demand for major surgeries within this population. Consequently, it is important to utilize accurate preoperative risk stratification techniques that are applicable to elderly individuals. Currently, commonly used preoperative risk assessments are subjective and often do not account for elderly-specific syndromes that may pose a hazard for geriatric patients if not addressed. Failure to accurately risk-stratify these patients may increase the risk of postoperative complications, morbidity, and mortality. Therefore, we aimed to identify and discuss the more objective and better-validated measurements indicative of poor surgical outcomes in the elderly with special focus on frailty, patient optimization, functional status, and cognitive ability.
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
Preeya K. Mistry
Geoffrey S. Gaunay
David M. Hoenig
关键词:  Frailty  Prediction  Outcomes  Surgical risks  Complications    
Abstract: As the number of Americans aged 65 years and older continues to rise, there is projected to be a corresponding increase in demand for major surgeries within this population. Consequently, it is important to utilize accurate preoperative risk stratification techniques that are applicable to elderly individuals. Currently, commonly used preoperative risk assessments are subjective and often do not account for elderly-specific syndromes that may pose a hazard for geriatric patients if not addressed. Failure to accurately risk-stratify these patients may increase the risk of postoperative complications, morbidity, and mortality. Therefore, we aimed to identify and discuss the more objective and better-validated measurements indicative of poor surgical outcomes in the elderly with special focus on frailty, patient optimization, functional status, and cognitive ability.
Key words:  Frailty    Prediction    Outcomes    Surgical risks    Complications
收稿日期:  2016-06-30      修回日期:  2016-07-04           出版日期:  2017-01-01      发布日期:  2017-02-16      整期出版日期:  2017-01-01
通讯作者:  David M. Hoenig,E-mail addresses:Dhoenig@northwell.edu,Dhoenigmd@gmail.com    E-mail:  Dhoenig@northwell.edu,Dhoenigmd@gmail.com
引用本文:    
Preeya K. Mistry, Geoffrey S. Gaunay, David M. Hoenig. Prediction of surgical complications in the elderly: Can we improve outcomes?[J]. Asian Journal of Urology, 2017, 4(1): 44-49.
Preeya K. Mistry, Geoffrey S. Gaunay, David M. Hoenig. Prediction of surgical complications in the elderly: Can we improve outcomes?. Asian Journal of Urology, 2017, 4(1): 44-49.
链接本文:  
http://www.ajurology.com/CN/  或          http://www.ajurology.com/CN/Y2017/V4/I1/44
[1] Vincent GK, Velkoff VA. The next four decades, the older population in the United States:2010e2050. Washington, D.C:U.S. Census Bureau; 2010. Available from:http://www. census.gov/prod/2010pubs/p25-1138.pdf.
[2] Etzioni DA, Liu JH, O'Connell JB, Maggard MA, Ko CY. Elderly patients in surgical workloads:a population-based analysis. Am Surg 2003;69:961e5.
[3] Hall MJ, DeFrances CJ, Williams SN, Golosinskiy A, Schwartzman A. National hospital discharge survey:2007 summary. Natl Health Stat Rep 2010;29:1e20. 4.
[4] Owens WD, Felts JA, Spitznagel Jr E. ASA physical status classifications:a study of consistency of ratings. Anesthesiology 1978;49:239e43.
[5] Makary MA, Segev DL, Pronovost PJ, Syin D, Bandeen-Roche K, Patel P, et al. Frailty as a predictor of surgical outcomes in older patients. J Am Coll Surg 2010;210:901e8.
[6] Le Manach Y, Collins G, Rodseth R, Le Bihan-Benjamin C, Biccard B, Riou B, et al. Preoperative score to predict postoperative mortality (POSPOM):derivation and validation. Anesthesiology 2016;124:570e9.
[7] Kim SW, Han HS, Jung HW, Kim KI, Hwang DW, Kang SB, et al. Multidimensional frailty score for the prediction of postoperative mortality risk. JAMA Surg 2014;149:633e40.
[8] Partridge JS, Harari D, Martin FC, Dhesi JK. The impact of preoperative comprehensive geriatric assessment on postoperative outcomes in older patients undergoing scheduled surgery:a systematic review. Anaesthesia 2014;69(Suppl. 1):8e16.
[9] Liao L, Mark DB. Clinical prediction models:are we building better mousetraps? J Am Coll Cardiol 2003;42:851e3.
[10] Xue QL. The frailty syndrome:definition and natural history. Clin Geriatr Med 2011;27:1e15.
[11] Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005;173:489e95.
[12] Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity:implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 2004;59:255e63.
[13] Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons:a systematic review. J Am Geriatr Soc 2012;60:1487e92.
[14] Saxton A, Velanovich V. Preoperative frailty and quality of life as predictors of postoperative complications. Ann Surg 2011; 253:1223e9.
[15] Hamel MB, Henderson WG, Khuri SF, Daley J. Surgical outcomes for patients aged 80 and older:morbidity and mortality from major noncardiac surgery. J Am Geriatr Soc 2005;53:424e9.
[16] Lee JS, He K, Harbaugh CM, Schaubel DE, Sonnenday CJ, Wang SC, et al. Frailty, core muscle size, and mortality in patients undergoing open abdominal aortic aneurysm repair. J Vasc Surg 2011;53:912e7.
[17] Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies:development and validation. J Chronic Dis 1987;40:373e83.
[18] Koppie TM, Serio AM, Vickers AJ, Vora K, Dalbagni G, Donat SM, et al. Age-adjusted Charlson comorbidity score is associated with treatment decisions and clinical outcomes for patients undergoing radical cystectomy for bladder cancer. Cancer 2008;112:2384e92.
[19] Podsiadlo D, Richardson S. The timed "Up & Go":a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142e8.
[20] Kim SM, Kim MJ, Jung HA, Kim K, Kim SJ, Jang JH, et al. Comparison of the Freiburg and Charlson comorbidity indices in predicting overall survival in elderly patients with newly diagnosed multiple myeloma. Biomed Res Int 2014;2014:437852.
[21] Inouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric syndromes:clinical, research, and policy implications of a core geriatric concept. J Am Geriatr Soc 2007;55:780e91.
[22] Robinson TN, Eiseman B, Wallace JI, Church SD, McFann KK, Pfister SM, et al. Redefining geriatric preoperative assessment using frailty, disability and co-morbidity. Ann Surg 2009;250:449e55.
[23] Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults:evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56:M146e56.
[24] Makary MA, Segev DL, Pronovost PJ, Syin D, Bandeen-Roche K, Patel P, et al. Frailty as a predictor of surgical outcomes in older patients. J Am Coll Surg 2010;210:901e8.
[25] Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, et al. Frequency of malnutrition in older adults:a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 2010;58:1734e8.
[26] Wolinsky FD, Coe RM, McIntosh WA, Kubena KS, Prendergast JM, Chavez MN, et al. Progress in the development of a nutritional risk index. J Nutr 1990;120(Suppl. 11):1549e53.
[27] DeJong PC, Von Meyenfeldt MR, Rouflart M, Wesdorp RI, Soeters PB. Complications of central venous catheterization of the subclavian vein:the influence of a parenteral nutrition team. Acta Anaesthesiol Scand Suppl 1985;81:48e52.
[28] Cohendy R, Rubenstein LZ, Eledjam JJ. The mini nutritional assessment-short form for preoperative nutritional evaluation of elderly patients. Aging 2001;13:293e7.
[29] Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, et al. Validation of the mini nutritional assessment short-form (MNA-SF):a practical tool for identification of nutritional status. J Nutr Health Aging 2009;13:782e8.
[30] Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA, et al. What is subjective global assessment of nutritional status? JPEN J Parenter Enter Nutr 1987;11:8e13.
[31] Poulia KA, Yannakoulia M, Karageorgou D, Gamaletsou M, Panagiotakos DB, Sipsas NV, et al. Evaluation of the efficacy of six nutritional screening tools to predict malnutrition in the elderly. Clin Nutr 2012;31:378e85.
[32] Golladay GJ, Satpathy J, Jiranek WA. Patient optimizationstrategies that work:malnutrition. J Arthroplasty 2016;31:1631e4.
[33] Kim S, Brooks AK, Groban L. Preoperative assessment of the older surgical patient:honing in on geriatric syndromes. Clin Interv Aging 2015;10:13e27.
[34] Chen TY, Anderson DJ, Chopra T, Choi Y, Schmader KE, Kaye KS. Poor functional status is an independent predictor of surgical site infections due to methicillin-resistant Staphylococcus aureus in older adults. J Am Geriatr Soc 2010;58:527e32.
[35] Arozullah AM, Daley J, Henderson WG, Khuri SF. Multifactorial risk index for predicting postoperative respiratory failure in men after major noncardiac surgery. Natl Veterans Adm Surg Qual Improv Program Ann Surg 2000;232:242e53.
[36] Legner VJ, Doerner D, Reilly DF, McCormick WC. Risk factors for nursing home placement following major nonemergent surgery. Am J Med 2004;117:82e6.
[37] Culley DJ, Flaherty D, Reddy S, Fahey MC, Rudolph J, Huang CC, et al. Preoperative cognitive stratification of older elective surgical patients:a cross-sectional study. Anesth Analg 2016;123:186e92.
[38] Manly JJ, Tang MX, Schupf N, Stern Y, Vonsattel JP, Mayeux R. Frequency and course of mild cognitive impairment in a multiethnic community. Ann Neurol 2008;63:494e506.
[39] Busse A, Hensel A, Guhne U, Angermeyer MC, RiedelHeller SG. Mild cognitive impairment:long-term course of four clinical subtypes. Neurology 2006;67:2176e85.
[40] Petersen RC. Clinical practice. Mild cognitive impairment. N Engl J Med 2011;364:2227e34.
[41] Plassman BL, Langa KM, Fisher GG, Heeringa SG, Weir DR, Ofstedal MB, et al. Prevalence of cognitive impairment without dementia in the United States. Ann Intern Med 2008; 148:427e34.
[42] Galanakis P, Bickel H, Gradinger R, Von Gumppenberg S, Forstl H. Acute confusional state in the elderly following hip surgery:incidence, risk factors and complications. Int J Geriatr Psychiatry 2001;16:349e55.
[43] Saczynski JS, Inouye SK, Kosar CM, Tommet D, Marcantonio ER, Fong T, et al. Cognitive and brain reserve and the risk of postoperative delirium in older patients:analysis of data from a prospective observational study. Lancet Psychiatry 2014;1:437e43.
[44] Chow WB, Rosenthal RA, Merkow RP, Ko CY, Esnaola NF, American College of Surgeons National Surgical Quality Improvement P, et al. Optimal preoperative assessment of the geriatric surgical patient:a best practices guideline from the American College of surgeons National surgical quality improvement Program and the American geriatrics society. J Am Coll Surg 2012;215:453e66.
[45] Robinson TN, Wu DS, Pointer LF, Dunn CL, Moss M. Preoperative cognitive dysfunction is related to adverse postoperative outcomes in the elderly. J Am Coll Surg 2012;215:12e8.
[46] Aykut K, Albayrak G, Guzeloglu M, Baysak A, Hazan E. Preoperative mild cognitive dysfunction predicts pulmonary complications after coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth 2013;27:1267e70.
[47] Ansaloni L, Catena F, Chattat R, Fortuna D, Franceschi C, Mascitti P, et al. Risk factors and incidence of postoperative delirium in elderly patients after elective and emergency surgery. Br J Surg 2010;97:273e80.
[48] Marcantonio ER, Goldman L, Mangione CM, Ludwig LE, Muraca B, Haslauer CM, et al. A clinical prediction rule for delirium after elective noncardiac surgery. JAMA 1994;271:134e9.
[49] Robinson TN, Raeburn CD, Tran ZV, Angles EM, Brenner LA, Moss M. Postoperative delirium in the elderly:risk factors and outcomes. Ann Surg 2009;249:173e8.
[1] Per-Anders Abrahamsson. Intermittent androgen deprivation therapy in patients with prostate cancer:Connecting the dots[J]. Asian Journal of Urology, 2017, 4(4): 208-222.
[2] Darab Mehraban. Clinical value of intravesical prostatic protrusion in the evaluation and management of prostatic and other lower urinary tract diseases[J]. Asian Journal of Urology, 2017, 4(3): 174-180.
[3] Kai Zhang, Chris H. Bangma, Monique J. Roobol. Prostate cancer screening in Europe and Asia[J]. Asian Journal of Urology, 2017, 4(2): 86-95.
[4] Ricardo Palmerola, Vinay Patel, Christopher Hartman, Chris Sung, David Hoenig, Arthur D. Smith, Zeph Okeke. Renal functional outcomes are not adversely affected by selective angioembolization following percutaneous nephrolithotomy[J]. Asian Journal of Urology, 2017, 4(1): 27-30.
[5] Bradley Morganstern, Riccardo Galli, Piruz Motamedinia, David Leavitt, Mohamed Keheila, Eric Ghiraldi, David Hoenig, Arthur Smith, Zeph Okeke. Percutaneous nephrolithotomy in octogenarians and beyond: How old is too old?[J]. Asian Journal of Urology, 2015, 2(4): 208-213.
[1] Zhixiang Wang, Bing Liu, Xiaofeng Gao, Yi Bao, Yang Wang, Huamao Ye, Yinghao Sun, Linhui Wang. Laparoscopic ureterolysis with simultaneous ureteroscopy and percutaneous nephroscopy for treating complex ureteral obstruction after failed endoscopic intervention: A technical report[J]. Asian Journal of Urology, 2015, 2(4): 238 -243 .
[2] Louis R. Kavoussi. News from leading international academic urology departments[J]. Asian Journal of Urology, 2017, 4(1): 1 -2 .
[3] Rikiya Taoka, Yoshiyuki Kakehi. The influence of asymptomatic inflammatory prostatitis on the onset and progression of lower urinary tract symptoms in men with histologic benign prostatic hyperplasia[J]. Asian Journal of Urology, 2017, 4(3): 158 -163 .
[4] Cheuk Fan Shum, Weida Lau, Chang Peng Colin Teo. Medical therapy for clinical benign prostatic hyperplasia:a1 Antagonists, 5a reductase inhibitors and their combination[J]. Asian Journal of Urology, 2017, 4(3): 185 -190 .
[5] Foo Keong Tatt. Current consensus and controversies on male LUTS/BPH (part two)[J]. Asian Journal of Urology, 2018, 5(1): 8 -9 .
[6] Rishi R. Sekar, Claire M. De La Calle, Dattatraya Patil, Sarah A. Holzman, Yoram Baum, Umer Sheikh, Jonathan H. Huang, Adeboye O. Osunkoya, Brian P. Pollack, Haydn T. Kissick, Kenneth Ogan, Viraj A. Master. Major histocompatibility complex I upregulation in clear cell renal cell carcinoma is associated with increased survival[J]. Asian Journal of Urology, 2016, 3(2): 75 -81 .
[7] Ryan Yu, Jefferson Terry, Mutaz Alnassar, Jorge Demaria. Pediatric fibrous pseudotumor of the tunica vaginalis testis[J]. Asian Journal of Urology, 2016, 3(2): 99 -102 .
[8] Aso Omer Rashid, Saman Salih Fakhulddin. Risk factors for fever and sepsis after percutaneous nephrolithotomy[J]. Asian Journal of Urology, 2016, 3(2): 82 -87 .
[9] Christopher Hartman, Nikhil Gupta, David Leavitt, David Hoenig, Zeph Okeke, Arthur Smith. Advances in percutaneous stone surgery[J]. Asian Journal of Urology, 2015, 2(1): 26 -32 .
[10] Aldamanhori Reem,I.Osman Nadir,R.Chapple Christopher. Underactive bladder: Pathophysiology and clinical significance[J]. Asian Journal of Urology, 2018, 5(1): 17 -21 .
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed