Management of postoperative complications: cardiovascular disease and volume management.
Postoperative cardiovascular complications are common, predictable, and typically treatable in geriatric patients who have sustained fractures. Although intervention-specific data are sparse, observational evidence from high-performing geriatric fracture centers coupled with an understanding of geriatric principles can serve as a basis for treatment guidelines. Many patients can be safely and effectively managed with close attention to intravascular volume status, heart rate control, and minimization of other physiologic stresses, including pain and delirium. Many chronic cardiovascular therapies may be harmful in the immediate postoperative period, and can usually be safely omitted or attenuated until hemodynamic stability and mobility have been restored.
Division of Geriatrics, Highland Hospital, University of Rochester School of Medicine, 1000 South Avenue Box 58, Rochester, NY 14610, USA. Electronic address: Joseph_Nicholas@urmc.rochester.edu.
Joseph A
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Nicholas
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D001810:Blood Volume; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D015897:Comorbidity; D050723:Fractures, Bone / Q000601:surgery*; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*; D018570:Risk Assessment / Q000379:methods
Cardiovascular disease; Geriatric fracture management; Postoperative complications