How to optimize patients for geriatric fracture surgery.
Low-energy fragility fractures account for >80% of fractures in elderly patients, and with aging populations, geriatric fracture surgery makes up a substantial proportion of the orthopedic workload. Elderly patients have markedly less physiologic reserve than do younger patients, and comorbidity is common. Even with optimal care, the risk of mortality and morbidity remains high. Multidisciplinary care, including early orthogeriatric input, is recommended to anticipate and treat complications. This article explores modern treatment strategies for this challenging group of patients and provides guidance for systematically preparing and optimizing elderly patients before surgery, based on best available current evidence and recommendations by relevant health organizations.
Department of Orthopaedic Surgery, Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
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Kates
D000368:Aged; D000698:Analgesia / Q000379:methods; D000925:Anticoagulants / Q000008:administration & dosage; D002318:Cardiovascular Diseases / Q000517:prevention & control; D015897:Comorbidity; D006305:Health Status Indicators; D006620:Hip Fractures / Q000601:surgery; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis; D058866:Osteoporotic Fractures / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods*; D018570:Risk Assessment / Q000379:methods; D013997:Time Factors
D000925:Anticoagulants