TY - JOUR
T1 - Perioperative Management of Elderly patients (PriME)
T2 - recommendations from an Italian intersociety consensus
AU - Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI), Società Italiana di Gerontologia e Geriatria (SIGG), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia Geriatrica (SICG) and Associazione Italiana di Psic
AU - Aceto, Paola
AU - Antonelli Incalzi, Raffaele
AU - Bettelli, Gabriella
AU - Carron, Michele
AU - Chiumiento, Fernando
AU - Corcione, Antonio
AU - Crucitti, Antonio
AU - Maggi, Stefania
AU - Montorsi, Marco
AU - Pace, Maria Caterina
AU - Petrini, Flavia
AU - Tommasino, Concezione
AU - Trabucchi, Marco
AU - Volpato, Stefano
N1 - Funding Information:
This work, including travel and meeting expenses, was supported by an unrestricted grant from MSD Italia Srl. The sponsor had no role in selecting the participants, reviewing the literature, defining consensus statements, drafting or reviewing the paper, or in the decision to submit the manuscript. All views expressed are solely those of the authors.
Publisher Copyright:
© 2020, The Author(s).
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Background: Surgical outcomes in geriatric patients may be complicated by factors such as multiple comorbidities, low functional performance, frailty, reduced homeostatic capacity, and cognitive impairment. An integrated multidisciplinary approach to management is, therefore, essential in this population, but at present, the use of such an approach is uncommon. The Perioperative Management of Elderly patients (PriME) project has been established to address this issue. Aims: To develop evidence-based recommendations for the integrated care of geriatric surgical patients. Methods: A 14-member Expert Task Force of surgeons, anesthetists, and geriatricians was established to develop evidence-based recommendations for the pre-, intra-, and postoperative care of hospitalized older patients (≥ 65 years) undergoing elective surgery. A modified Delphi approach was used to achieve consensus, and the strength of recommendations and quality of evidence was rated using the U.S. Preventative Services Task Force criteria. Results: A total of 81 recommendations were proposed, covering preoperative evaluation and care (30 items), intraoperative management (19 items), and postoperative care and discharge (32 items). Conclusions: These recommendations should facilitate the multidisciplinary management of older surgical patients, integrating the expertise of the surgeon, the anesthetist, the geriatrician, and other specialists and health care professionals (where available) as needed. These roles may vary according to the phase and setting of care and the patient’s conditions.
AB - Background: Surgical outcomes in geriatric patients may be complicated by factors such as multiple comorbidities, low functional performance, frailty, reduced homeostatic capacity, and cognitive impairment. An integrated multidisciplinary approach to management is, therefore, essential in this population, but at present, the use of such an approach is uncommon. The Perioperative Management of Elderly patients (PriME) project has been established to address this issue. Aims: To develop evidence-based recommendations for the integrated care of geriatric surgical patients. Methods: A 14-member Expert Task Force of surgeons, anesthetists, and geriatricians was established to develop evidence-based recommendations for the pre-, intra-, and postoperative care of hospitalized older patients (≥ 65 years) undergoing elective surgery. A modified Delphi approach was used to achieve consensus, and the strength of recommendations and quality of evidence was rated using the U.S. Preventative Services Task Force criteria. Results: A total of 81 recommendations were proposed, covering preoperative evaluation and care (30 items), intraoperative management (19 items), and postoperative care and discharge (32 items). Conclusions: These recommendations should facilitate the multidisciplinary management of older surgical patients, integrating the expertise of the surgeon, the anesthetist, the geriatrician, and other specialists and health care professionals (where available) as needed. These roles may vary according to the phase and setting of care and the patient’s conditions.
KW - Analgesia
KW - Anesthesia
KW - Comprehensive geriatric assessment
KW - Frail older
KW - Older patients
KW - Perioperative care
KW - Surgery
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U2 - 10.1007/s40520-020-01624-x
DO - 10.1007/s40520-020-01624-x
M3 - Article
C2 - 32651902
AN - SCOPUS:85087837047
SN - 1594-0667
VL - 32
SP - 1647
EP - 1673
JO - Aging clinical and experimental research
JF - Aging clinical and experimental research
IS - 9
ER -