Re: Optimal preoperative assessment of the geriatric surgical patient: A best practices guideline from the american college of surgeons national surgical quality improvement program and the american geriatrics society

摘要

Editorial Comment: This special article presents an excellent overview and best practice guideline for dealing with preoperative assessment of the geriatric surgical patient. A detailed checklist is provided that includes, in addition to the routine history and physical examination, assessment of cognitive impairment and dementia, screening for depression, risk factors for postoperative delirium and alcohol or substance abuse. In addition, assessment of functional status, frailty and nutritional status are outlined. There is a detailed review of preoperative testing and when it should and should not be applied. The guideline states that routine preoperative screening is not recommended, with the exception of hemoglobin, renal function and albumin tests, which should always be performed. They also emphasize that diagnostic tests should be performed selectively. This guideline is an excellent resource for urological surgeons working with the elderly.