RT Book, Section 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. SR Print(0) ID 1164321335 T1 Surgical Considerations in Older Adults T2 Schwartz's Principles of Surgery, 11e YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9781259835353 LK accessmedicine.mhmedical.com/content.aspx?aid=1164321335 RD 2024/10/08 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.