Perioperative Management of Elderly patients (PriME): recommendations from an Italian intersociety consensus

Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI), Società Italiana di Gerontologia e Geriatria (SIGG), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia Geriatrica (SICG) and Associazione Italiana di Psicogeriatria (AIP)

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Surgical outcomes in geriatric patients may be complicated by factors such as multiple comorbidities, low functional performance, frailty, reduced homeostatic capacity, and cognitive impairment. An integrated multidisciplinary approach to management is, therefore, essential in this population, but at present, the use of such an approach is uncommon. The Perioperative Management of Elderly patients (PriME) project has been established to address this issue. Aims: To develop evidence-based recommendations for the integrated care of geriatric surgical patients. Methods: A 14-member Expert Task Force of surgeons, anesthetists, and geriatricians was established to develop evidence-based recommendations for the pre-, intra-, and postoperative care of hospitalized older patients (≥ 65 years) undergoing elective surgery. A modified Delphi approach was used to achieve consensus, and the strength of recommendations and quality of evidence was rated using the U.S. Preventative Services Task Force criteria. Results: A total of 81 recommendations were proposed, covering preoperative evaluation and care (30 items), intraoperative management (19 items), and postoperative care and discharge (32 items). Conclusions: These recommendations should facilitate the multidisciplinary management of older surgical patients, integrating the expertise of the surgeon, the anesthetist, the geriatrician, and other specialists and health care professionals (where available) as needed. These roles may vary according to the phase and setting of care and the patient’s conditions.

Original languageEnglish
Pages (from-to)1647-1673
Number of pages27
JournalAging clinical and experimental research
Volume32
Issue number9
DOIs
Publication statusPublished - Sep 1 2020

Keywords

  • Analgesia
  • Anesthesia
  • Comprehensive geriatric assessment
  • Frail older
  • Older patients
  • Perioperative care
  • Surgery

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology

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