Outpatient Surgery Magazine

No More Never Events - February 2014 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Mark Katlic, MD, MMM, FACS SAFETY 1 3 0 O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | F E B R U A R Y 2 0 1 4 Gear Up for Geriatrics They can handle surgery, but not the complications of surgery. T he results of surgery in the elderly are typically worse than sur- gery in younger age groups. Some hospitals and surgery centers achieve excellent results with geriatric patients, but data from across the country show that being elderly is a risk factor for surgery. They experience more complications, longer lengths of stay, longer times in the OR and recovery, and more deaths. Here are practical steps we can take to protect our older patients. In pre-op You typically do routine blood tests and listen to the heart and lungs, perhaps ask for EKGs and chest X-rays, and consult with a cardiologist or internist to ensure patients are stable for surgery. A more comprehensive pre-op clinical evaluation of elderly patients presenting for elective sur- gery could also include a test for frailty, which involves assessing handgrip strength and gait speed, and historical questions about weight loss and energy level. A timed-up-and-go test is a simple alternative. Also test for cognition, using a mini-cog test, which involves having patients recall 3 words and draw an accurate clock face, includ- ing numbers and hands, for a specified time. Conduct a hearing screening and an assess- ment of instrumental activities of daily living to determine patients' exec- utive functioning. BETTER WITH AGE Your perioperative team must step up its efforts when caring for older patients. OSE_1402_part3_Layout 1 2/6/14 3:02 PM Page 128

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