Perioperative Patientenführung in der Altersendoprothetik

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• 作者：P. Moldzio ; Prof. Dr. J. Peters
• 关键词：SchlüsselwörterAnästhesie ; Risikostratifizierung ; Geriatrie ; Antikoagulation ; Transfusion
• 刊名：Der Orthopäde
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：46
• 期：1
• 页码：54-62
• 全文大小：
• 刊物主题：Orthopedics; Chiropractic Medicine; Conservative Orthopedics; Surgical Orthopedics; Sports Medicine; Traumatic Surgery;
• 出版者：Springer Medizin
• ISSN：1433-0431
• 卷排序：46

文摘

The management of major orthopedic surgery in the elderly prototypically reflects the perioperative risks of geriatric, often very frail patients reflecting an aging population. To improve outcome, the risks of anesthesia and surgery as well as of patient comorbidities must be thoroughly assessed and balanced using a multidisciplinary approach. Particular risks include cardiopulmonary morbidity, anemia, risk of hemorrhage and the management by anticoagulation, cerebral impairments as well as frailty and limited physiological reserves in general. Accordingly, an optimized therapy prior to, during, and after surgery will likely influence not only the immediate postoperative course but also hospital mortality and long-term outcome. Publications on the topic of perioperative management of geriatric patients are fortunately gaining in quality and quantity, not least against the background of the demographic developments. Accordingly, specific influencing factors relevant for perioperative management can be increasingly more identified. This short review summarizes the current state of knowledge to provide an overview and rationale for clinical decision making.