Preoperative optimization and risk assessment

Because most older adults with hip fractures require urgent surgical intervention, the preoperative medical evaluation focuses on the exclusion of the small number of contraindications to surgery, and rapid optimization of patients for operative repair. Although many geriatric fracture patients have...

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Bibliographic Details
Published inClinics in geriatric medicine Vol. 30; no. 2; p. 207
Main Author Nicholas, Joseph A
Format Journal Article
LanguageEnglish
Published United States 01.05.2014
Subjects
Aged
Aged, 80 and over
Comorbidity
Frail Elderly
Geriatric Assessment - methods
Hip Fractures - surgery
Humans
Postoperative Complications - prevention & control
Preoperative Care
Risk Assessment - methods
Geriatric fracture management
Cardiovascular disease
Preoperative risk assessment
Preoperative care
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Summary:Because most older adults with hip fractures require urgent surgical intervention, the preoperative medical evaluation focuses on the exclusion of the small number of contraindications to surgery, and rapid optimization of patients for operative repair. Although many geriatric fracture patients have significant chronic medical comorbidities, most patients can be safely stabilized for surgery with medical and orthopedic comanagement by anticipating a small number of common physiologic responses and perioperative complications. In addition to estimating perioperative risk, the team should focus on intravascular volume restoration, pain control, and avoidance of perioperative hypotension.
ISSN:1879-8853
DOI:10.1016/j.cger.2014.01.003