Knowledge, attitude, and practices of Indian anesthesiologists regarding the comprehensive preanesthetic assessment of geriatric patients: A cross-sectional survey

Abstract

Background: Comprehensive preoperative geriatric evaluations, including frailty, diet, mobility aid use, physical activity, cognitive testing, and mood state assessment, help predict perioperative outcomes in elderly patients. Material and Methods: An online questionnaire-based Google survey was prepared to assess preanesthetic checkup (PAC) in elderly patients by practicing anesthesiologists over 3 months. Data about respondent demographics, knowledge about preoperative investigations, and utilization of validated tools for risk assessment in geriatric patients were collected and analyzed descriptively using different percentages and frequencies. Results: The invitation was sent to 500 anesthesiologists. One hundred and fifty-six recipients responded to the e-mail invitation producing an overall response rate of 31.2%. About 47.4% and 42.4% of anesthesiologists had an equal preference for regional/general anesthesia in conducting elderly elective cases for surgeries, the choice of anesthesia was mainly regional anesthesia in cognitively impaired elderly patients. Nearly 88.5% and 78.2% of practicing anesthesiologists were well aware and conducted the functional assessment and mini—mental state examination in geriatric patients, but only 48.7% were aware of frailty scoring, 30.8% were aware of Charlson comorbidity scoring index, and 24.4% were about Elderly Mobility Scale (EMS). Conclusion: Surgical results are strongly influenced by the general health, work, and life expectancy of patients. A comprehensive preoperative geriatric evaluation of patients must be extended beyond an organ-based or disease-based evaluation. We support the inclusion in the PAC of geriatric patients of validated score systems, including frailty score, Charlson comorbidity score index, EMS, functional assessment, and mini—mental state assessment.