The problem of preoperative assessment of patients of older age groups

D. V. Trotsyuk, Z. Zaripova, D. S. Medvedev, A. Volkov
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Abstract

Age-associated processes combined with comorbidity affect the physiological reserves of patients of older age groups, having a negative impact on the surgery and the postoperative period. One of the most important geriatric syndromes, closely related to the treatment outcome in patients over 60, is frailty. The prevalence of frailty increases with age, and that is associated with a worsening of the perioperative prognosis, prolonged hospitalization, and an increase in mortality. The methods widely used for perioperative risk stratification do not take into account the presence and severity of frailty, changes in the functional state and reserve capabilities of the body, which reduces their sensitivity for patients of older age groups. The article considers the generally accepted approaches to risk stratification and identifies further development prospects in this area.
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高龄患者术前评估的问题
年龄相关的过程和合并症会影响老年患者的生理储备,对手术和术后产生负面影响。与60岁以上患者的治疗结果密切相关的最重要的老年综合征之一是虚弱。虚弱的患病率随着年龄的增长而增加,这与围手术期预后的恶化、住院时间的延长和死亡率的增加有关。目前广泛应用的围手术期风险分层方法,没有考虑到虚弱的存在和严重程度、机体功能状态的变化和储备能力,降低了对老年患者的敏感性。本文考虑了普遍接受的风险分层方法,并确定了这一领域的进一步发展前景。
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