Perioperative Care of the Elderly
Clinical and Organizational Aspects

This innovative, comprehensive book covers key elements of perioperative management of older patients, from preoperative evaluation to post-hospital care.

Gabriella Bettelli (Edited by)

9781107139343, Cambridge University Press

Hardback, published 16 November 2017

376 pages, 16 b/w illus. 12 colour illus. 43 tables
25.3 x 19.2 x 2.2 cm, 0.98 kg

'[Perioperative Care of the Elderly is] a very comprehensive volume that deserves a place on the surgical ward and operating theatre coffee room. … I would strongly recommend the book for specialty trainees in anaesthesia and surgery. Those in geriatric medicine will find certain sections of use, particularly to understand the work of our anaesthetic and surgical colleagues.' Shane O'Hanlon, British Geriatrics Society (www.bgs.org.uk)

This innovative, comprehensive book covers the key elements of perioperative management of older patients. The book's chapter structure coincides with the clinical path patients tread during their treatment, from preoperative evaluation to post-hospital care. Epidemiological aspects and aging processes are illustrated, providing keys to understanding the quick expansion of geriatric surgery and defining the clinical profile of older surgical patients in a cybernetic perspective. Preoperative evaluation and preparation for surgery, including medication reconciliation and pre-habilitation, are developed in the light of supporting decision-making about surgery in an evidence-based and patient-focused way. Intra- and postoperative management are discussed, aiming to tailor anesthetic, surgical and nursing approaches to specific patients' needs, in order to prevent both general and age-related complications. This volume also addresses issues relevant to geriatric surgery, from different organizational models to clinical risk management and systems engineering applied to hospital organization.

Foreword
Preface
Introduction: population aging, healthcare systems and surgery
Part I. Preoperative Evaluation: 1. Aging and age-related functional changes
2. Preoperative evalution: a 360° perspective
3. Comorbidities and multimorbidity
4. Poly-medication and perioperative drugs management
5. Assessment of functional reserves
6. Cognitive and emotional evaluation
7. Sensorial evaluation and impact of hearing and visual impairment on communication
8. Preoperative testing
9. Team-based discussion on preoperative evaluation and decision-making about surgery
10. Communication and informed consent
11. Preoperative care in emergency surgery
Part II. Preparation to Surgery: 12. Prehabilitation: how to enhance cardio-respiratory functional reserves before surgery
13. Diagnosis and treatment of nutritional deficits
14. Prevention of cognitive complications
15. Psychological support in elderly surgical patients
16. The role of geriatric nurses in preparing the elderly for surgery
Part III. Intraoperative Management: 17. Entering the operating theatre: a challenging experience
18. Safety in the operating room: special needs of geriatric patients
19. The geriatric patient and anesthesia
20. Regional anesthesia techniques
21. Fluids and electrolytes management
22. Surgery in the elderly: general considerations
23. Cancer surgery and the elderly
24. Orthopedic surgery
25. Cardiovascular surgery
26. Thoracic surgery
27. Abdominal surgery
28. Day surgery
29. Cataract surgery and other office-based procedures
Part IV: Postoperative Management: 30. The elderly in the recovery room
31. Endocrine and metabolic response to surgical stress in the elderly
32. Postoperative pain treatment
33. General principles of postoperative recovery
34. Fast-track and ERAS programs in geriatric surgery
35. Postoperative nursing
36. Cardiovascular complications
37. Perioperative venous thromboembolism in the elderly: prevention and treatment
38. Treatment of postoperative delirium
39. Postoperative respiratory complications
40. Renal complications
41. Postoperative admission to the intensive care unit
42. Prevention of postoperative geriatric syndromes
43. Planning for discharge
44. Ethics in geriatric surgery, end of life and palliative care
Part V. Key Issues for Optimal Organization: 45. Models of care and organizational solutions for geriatric surgery
46. Hospital design
47. Patient's safety, ergonomics and clinical risk management
48. Systemic approach to management in GS: methods and tools
49. Systems engineering in GS: the contribute of modelling and simulation
50. Closing the loop with the client's perspective: how the elderly live the experience of surgery
Index.

Subject Areas: General surgery [MNC], Palliative medicine [MMC], Anaesthetics [MMB], Geriatric medicine [MJX]