TY - CHAP M1 - Book, Section TI - Surgical Considerations in Older Adults A1 - M. Suskind, Anne A1 - Finlayson, Emily A2 - Brunicardi, F. Charles A2 - Andersen, Dana K. A2 - Billiar, Timothy R. A2 - Dunn, David L. A2 - Kao, Lillian S. A2 - Hunter, John G. A2 - Matthews, Jeffrey B. A2 - Pollock, Raphael E. PY - 2019 T2 - Schwartz's Principles of Surgery, 11e AB - Key Points Frailty, dementia, and functional impairment are significant contributors to morbidity and mortality after surgery. Assessment of these risk factors is essential in an older population. Geriatric perioperative pathways are effective in preventing delirium, a morbid and costly postoperative complication that is associated with cognitive decline. Population-based data demonstrate that mortality after emergency surgery and high-risk cancer surgery is substantially higher in older adults that in a younger population. Impaired cardiac function is responsible for more than half of the postoperative deaths in older adult patients, so careful attention must be paid to intravascular volume status in the perioperative period. Many frail elders experience significant and sustained functional decline after surgery. Older adults with acute abdominal pathology—appendicitis, cholecystitis—often do not have fever, elevated white blood cell count, or physical findings of peritonitis. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/13 UR - accessmedicine.mhmedical.com/content.aspx?aid=1164321335 ER -