scholarly journals Cardiac surgery in the elderly: What goals of care?

2017 ◽  
Vol 87 (2) ◽  
Author(s):  
Alessandra Pratesi ◽  
Francesco Orso ◽  
Camilla Ghiara ◽  
Aldo Lo Forte ◽  
Anna Chiara Baroncini ◽  
...  

<p>At present, the majority of cardiac surgery interventions have been performed in the elderly with successful short-term mortality and morbidity, however significant difficulties must to be underlined about our capacity to predict long-term outcomes such as disability, worsening quality of life and loss of functional capacity.<br />The reason probably resides on inability to capture preoperative frailty phenotype with current cardiac surgery risk scores and consequently we are unable to outline the postoperative trajectory of an important patients’ centered outcome such as disability free survival. In this perspective, more than one geriatric statements have stressed the systematic underuse of patient reported outcomes in cardiovascular trials even after taking account of their relevance to older feel and wishes. Thus, in the next future is mandatory for geriatric cardiology community closes this gap of evidences through planning of trials in which patients’ centered outcomes are considered as primary goals of therapies as well as cardiovascular ones.</p>

1992 ◽  
Vol 3 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Carolyn S. Brown

A growing number of elderly patients (aged 70 years and older) are seen in critical care units after valve surgery or coronary artery bypass grafting. While studies show that the elderly demonstrate overall successful results after cardiac surgery, the mortality and morbidity risks are higher than in younger adults. The elderly patient is more likely to experience postoperative complications, prolonging the recovery phase. Commonly reported postoperative complications include dysrhythmias, pneumonia, cerebral vascular accidents, and infection. Elderly surgical candidates must be evaluated preoperatively to determine risk factors that may affect the critical care recovery phase. The length of stay tends to be longer in the intensive care unit, requiring nursing care that takes the aging process into consideration. The following article focuses on trends in cardiac surgery in the elderly, physiologic factors that affect outcome and recovery, and nursing interventions aimed at preventing or limiting postoperative complications


1996 ◽  
Vol 27 (2) ◽  
pp. 281 ◽  
Author(s):  
Maurice E. Sarano ◽  
Robert L. Frye ◽  
Hartzell V. Schaff ◽  
Thomas A. Orszulak ◽  
A.Jamil Tajik

Author(s):  
Margarita T. Camacho ◽  
Konstadinos A. Plestis ◽  
Jeffrey P. Gold

Author(s):  
Margarita T. Camacho ◽  
Pooja R. Raval

Author(s):  
Chris Dodds ◽  
Chandra M. Kumar ◽  
Frédérique Servin

Major abdominal surgery and laparotomy are common procedures that are associated with a high risk of mortality and morbidity, especially in the elderly. Outcomes can be improved by formal risk stratification, appropriate perioperative resuscitation and optimization, early surgery, senior anaesthetist involvement, and careful postoperative critical. Assessment of dehydration is imperative because fluid losses are very common and may be difficult to measure. Hypothermia is common, and measures should be instituted to conserve heat loss. Use of nitrous oxide can cause bowel distension and should be avoided. Elderly patients should receive postoperative care in an environment that is appropriate to the degree of comorbidity and the type of surgery. Effective analgesia is known to improve outcome. Only experienced anaesthetists should manage major and emergency abdominal surgery.


2019 ◽  
Vol 15 (5) ◽  
pp. 725-731 ◽  
Author(s):  
Jai Prasad ◽  
Ellen Vogels ◽  
James T. Dove ◽  
Craig Wood ◽  
Anthony T. Petrick ◽  
...  

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