Approach to Evaluating the Multimorbid Patient with Cardiovascular Disease Undergoing Noncardiac Surgery.
Older patients undergo more inpatient and outpatient procedures than do younger individuals, and their risk of suffering undesired outcomes is greater. The performance of a productive preoperative assessment entails more than the application of the sundry clinical practice guidelines relating to a patient's various medical diagnoses. A better approach involves adoption of a physiologically integrated, whole-person assessment that takes into account the patient's cognitive function, mood, physical function and mobility (including the possibility of frailty), social support, nutritional status, and medication use. This article outlines such an approach and highlights the many gaps in the current evidence base.
Division of Geriatrics, Department of Internal Medicine, University of Nebraska Medical Center, 986155 Nebraska Medical Center, Omaha, NE 68198-6155, USA. Electronic address: wlyons@unmc.edu.
William L
WL
Lyons
D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D055317:Evidence-Based Practice; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D018570:Risk Assessment; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000379:methods
Frailty; Geriatric assessment; Multimorbidity; Preoperative assessment