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Geriatric Surgery and Perioperative Care /

Geriatric Surgery and Perioperative Care presents clear evidence to support regulatory and financial decisions in the light of the value-based care principles.The book outlines standards of care for elderly patients undergoing surgery as well as minimal requirements for modern management aimed at de...

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Bibliographic Details
Corporate Author: ScienceDirect (Online service)
Other Authors: Bettelli, Gabriella (Editor), Audisio, Riccardo A. (Editor)
Format: eBook
Language:English
Published: London, England : Academic Press, [2025]
Edition:First edition.
Subjects:
Older people > Surgery.
Surgery.
Geriatrics
General Surgery
Perioperative Care
Personnes âgées > Chirurgie.
Chirurgie.
Soins périopératoires.
surgery (health care function)
Electronic books.
Online Access:Connect to the full text of this electronic book
Table of Contents:
  • Intro
  • Geriatric Surgery and Perioperative Care
  • Copyright
  • Contents
  • Contributors
  • Preface
  • Editors biography
  • Part 1: Preoperative management
  • Chapter 1: Epidemiological and structural overview
  • 1. Introduction
  • 2. Demographic and epidemiological overview
  • 2.1. General population aging
  • 2.2. General health patterns of the ancient population
  • Population aging and its impact on surgical activities
  • 3. Evolution of geriatric medicine in the different countries
  • 3.1. USA
  • 3.2. Europe
  • 3.3. Australia
  • 3.4. China
  • 3.5. India
  • 4. Origins and development of surgery in older persons
  • 4.1. Historical overview
  • Some historical data
  • The situation in the 2020s
  • 5. Organizational aspects
  • 6. Cost analysis and social impact
  • 7. How can we act to improve the situation?
  • References
  • Chapter 2: Aging, pathophysiological changes, and their impact on anesthesia and surgery
  • 1. Introduction
  • 2. Aging and homeostenosis
  • 3. Organ-related pathophysiological changes and associated conditions
  • 3.1. Cardiovascular system
  • 4. Respiratory system
  • 4.1. Renal system
  • 4.2. Central and peripheral nervous system
  • 4.3. Sensorial systems
  • 4.4. Metabolic functions
  • 4.5. Muscular and skeletal systems
  • 5. Cellular changes related to aging
  • 5.1. Cellular senescence
  • 5.2. Mitochondrial dysfunction and oxidative stress
  • 6. The immune system and the concept of inflammaging
  • 6.1. The innate immune response
  • Physical barriers
  • Cellular response
  • Pattern recognition receptors (PRRs)
  • The complement system
  • 6.2. The adaptive immune response
  • 6.3. Inflammaging
  • 7. Conclusion
  • References
  • Chapter 3: Preoperative evaluation and optimization: A team-based task
  • 1. Introduction
  • 1.1. Relevant guidelines on preoperative evaluation of the geriatric patient.
  • Perioperative care of the elderly, AAGBI 2014
  • Optimal preoperative evaluation of the older surgical patient, ACS/AGS/NSQIP 2015
  • Preliminary standards for quality surgical care for older adults, CQGS 2017
  • Preoperative evaluation of adults undergoing elective noncardiac surgery
  • Perioperative management of elderly patients: Recommendations from an Italian intersociety (PriME)
  • 1.2. What lesson should be learned from this evolution?
  • 1.3. How to proceed to update the preoperative evaluation process?
  • 2. What targets should be obtained: Comorbidity management, assessment of functional status, sensory optimization, surgic ...
  • 2.1. Comorbidity management
  • 2.2. The role of comprehensive geriatric assessment
  • 3. The role of surgeons and their interactions with the other team members
  • 4. The role of anesthesiologists
  • 4.1. What challenges should be overcome to update the preoperative anesthesia consultation?
  • 5. The role of geriatricians and their interactions with the other team members
  • 6. The role of nurses and their interactions with the other team members
  • 6.1. Clinical role: Assessment of bio-psycho-social needs, nursing diagnoses, and tailored interventions
  • 6.2. Patient education: A strategic approach for advancing health literacy
  • 6.3. Empathy in nursing interventions: A key factor in care quality and patient activation
  • 6.4. Effective communication within the perioperative multidisciplinary teams
  • 7. Prehabilitation strategies
  • 7.1. Physical training
  • 7.2. Nutrition intervention
  • 7.3. Psychological support
  • 7.4. Smoking cessation counseling
  • 7.5. Challenges in prehabilitation
  • 8. Conclusion
  • References
  • Chapter 4: Decision-making for surgery and hospital admission planning
  • 1. Introduction
  • 2. Surgical risk assessment
  • 2.1. Risk evaluation scores.
  • 2.2. Surgical risk assessment in older patients
  • 3. The geriatric surgical patient: Clinics and expectations
  • 3.1. Associated conditions and frailty
  • 3.2. Functional status
  • 3.3. Patient's expectations
  • 4. The surgical treatment
  • 5. The team-based discussion and the decision-making process
  • 5.1. Patient involvement in the decision process
  • 5.2. Ethical considerations
  • 5.3. Decision-making in persons with cognitive impairment undergoing surgery
  • 6. How nurses should prepare the patient for hospital admission
  • 6.1. How to individuate the best patient allocation in the facility
  • 6.2. Facility introduction to the patient: Ward visit and introduction to the ward nurses
  • 6.3. What objects should the patient bring in?
  • 6.4. Information about where and when patients are expected to arrive
  • 7. Conclusions
  • References
  • Chapter 5: Patient allocation and preparation to surgery
  • 1. Patient allocation in accordance with specific patient's needs
  • 2. Positioning of reorienting tools
  • 3. Risk of fall management
  • 4. The ideal bed for geriatric surgical patients
  • 5. Perioperative medication management
  • 6. Preoperative fasting
  • 7. Relatives access management and measures aimed to reduce anxiety before surgery
  • References
  • Part 2: Peri- and postoperative management
  • Chapter 6: Anesthesia techniques, intraoperative management, and early postoperative recovery
  • 1. Introduction
  • 2. General anesthesia
  • 2.1. General anesthesia agents
  • 3. Locoregional anesthesia
  • 4. Combined anesthesia
  • 5. Sedation
  • 6. Perioperative monitoring to reduce postoperative complications
  • 6.1. Monitoring to reduce delirium and POCD
  • 6.2. Temperature monitoring
  • 6.3. Perioperative pain monitoring
  • 6.4. Pulmonary complications
  • 6.5. Hemodynamic monitoring
  • 6.6. Perioperative feeding
  • 6.7. Pressure injuries.
  • 7. Identification of the appropriate postoperative monitoring setting
  • 8. Conclusions
  • References
  • Chapter 7: Team-based approach to surgical stress reduction and procedural safety
  • 1. Pathophysiology of the surgical stress response
  • 1.1. The surgical stress reaction: Endocrine dynamics and effects on the older patient
  • 1.2. The surgical stress reaction: Metabolic response to hormone incretion
  • 1.3. The surgical stress reaction: Immune reaction and cytokine release
  • 1.4. Aging and the surgical stress reaction
  • 2. Measures aimed to minimize SSR
  • 2.1. What surgeons can do to achieve the best results
  • 2.2. What anesthesiologists can do to achieve the best results
  • 2.3. What nurses can do to achieve the best results
  • 3. Entrance in the operative room and measures aimed to reduce anxiety
  • 3.1. Entering the OR
  • 3.2. Patient positioning on the surgical table
  • 4. The WHO safety checklist and implications for the older surgical patient
  • References
  • Chapter 8: General principles for optimal postoperative recovery*
  • 1. Aims and purposes of postoperative recovery
  • 1.1. Aspects of recovery
  • 1.2. Short-term
  • 1.3. Intermediate-term
  • 1.4. Long-term
  • 2. Principles and practical protocols of postoperative recovery
  • 2.1. Principles
  • 2.2. Practical protocols
  • 2.3. Postoperative analgesia
  • 2.4. Delirium
  • References
  • Chapter 9: Postoperative ICU care
  • 1. Introduction
  • 2. When is an ICU admission required?
  • 3. Cardiac and respiratory support
  • 3.1. Cardiovascular dysfunction/failure
  • 3.2. Monitoring
  • 3.3. Treatment of CV failure
  • 3.4. Treatment of respiratory failure
  • 4. Nutrition
  • 5. Prevention of delirium
  • 6. Limitation of active treatments and psychological aspects
  • 7. Criteria for discharge to the ward
  • 8. Conclusion
  • References.
  • Chapter 10: How should an older patient be managed after surgery?
  • 1. Introduction
  • 1.1. Epidemiological context
  • 1.2. Perioperative geriatric units
  • 1.3. Objectives and care approaches
  • 2. Analgesia and mobilization
  • 3. Nutritional supplementation
  • 4. Medico-surgical complications (Table 1)
  • 4.1. Delirium
  • 4.2. Anemia
  • 4.3. Cardiovascular complications
  • Supraventricular arrythmia
  • Heart failure
  • Myocardial infarction
  • 4.4. Postoperative fever
  • Urinary tract infection
  • Pulmonary infection
  • Surgical site infections
  • 4.5. Venous thromboembolism
  • 4.6. Acute kidney injury
  • 4.7. Gastrointestinal trouble
  • 4.8. Pressure ulcers
  • 5. Conclusion
  • References
  • Chapter 11: The clinical path: Management of hospital discharge and late postoperative recovery
  • 1. Introduction
  • 2. Team approach to the problem
  • 3. Prehospital social conditions
  • 4. Risk of developing posthospital syndrome
  • 5. Need for extended postdischarge care and rehabilitation
  • 6. Organizational standards
  • 7. Rehabilitation plan
  • 8. Preventing hospital readmission risk
  • 9. Discharge to home: When it's appropriate and when it's not
  • 10. Information for family and caregivers on fall prevention, nutrition, physical activity, social and cognitive stimulat ...
  • 11. Transfer to transitional care units: Indications and practice
  • 12. Quality of life after discharge
  • References
  • Part 3: Surgical issues
  • Chapter 12: Surgery for older patients: An overview
  • References
  • Chapter 13: The impact of ERAS in senior surgical patients
  • 1. General concepts
  • 2. Core items in elderly
  • 3. Elective surgery
  • 4. Emergency surgery
  • References
  • Chapter 14: Breast surgery in older women
  • References
  • Chapter 15: Thoracic surgery in elderly patients
  • 1. Introduction
  • 1.1. Screening guidelines and decision-making for older patients.