Surgery on elderly patients.

• With the ageing of the population more older people now are undergoing general anaesthetics and major surgery.

• Evidence is accumulating that comprehensive holistic Geriatric Medical care and assessment before and after surgery makes a huge difference to the outcome of the surgery, avoids complications, reduces the risk of post-operative delirium and post-operative cognitive decline.

• All Surgeons who operate on older patients must have training in Geriatric Medicine and work closely with a Geriatrician in a multi-disciplinary care setting to achieve safe and effective surgical outcomes.

• There should be a clear overall plan before major surgery as to how to manage fluid balance, post-operative anaemia, blood transfusions, post-operative pain, drugs, early mobility and preventing adverse drug reactions, and post-operative cognitive decline.

• There is no point in operating on elderly patients if the outcome is poor because of multiple complications such as post op delirium, falls, malnutrition, poor mobility and adverse drug reactions. It’s a bit like saying “well the operation was a success, but what about the patient”?

For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.