Author:
Tian Brian W. C. A.,Stahel Philip F.,Picetti Edoardo,Campanelli Giampiero,Di Saverio Salomone,Moore Ernest,Bensard Denis,Sakakushev Boris,Galante Joseph,Fraga Gustavo P.,Koike Kaoru,Di Carlo Isidoro,Tebala Giovanni D.,Leppaniemi Ari,Tan Edward,Damaskos Dimitris,De’Angelis Nicola,Hecker Andreas,Pisano Michele,YunfengCui ,Maier Ron V.,De Simone Belinda,Amico Francesco,Ceresoli Marco,Pikoulis Manos,Weber Dieter G.,Biffl Walt,Beka Solomon Gurmu,Abu-Zidan Fikri M.,Valentino Massimo,Coccolini Federico,Kluger Yoram,Sartelli Massimo,Agnoletti Vanni,Chirica Mircea,Bravi Francesca,Sall Ibrahima,Catena Fausto
Abstract
AbstractMany countries are facing an aging population. As people live longer, surgeons face the prospect of operating on increasingly older patients. Traditional teaching is that with older age, these patients face an increased risk of mortality and morbidity, even to a level deemed too prohibitive for surgery. However, this is not always true. An active 90-year-old patient can be much fitter than an overweight, sedentary 65-year-old patient with comorbidities. Recent literature shows that frailty—an age-related cumulative decline in multiple physiological systems, is therefore a better predictor of mortality and morbidity than chronological age alone. Despite recognition of frailty as an important tool in identifying vulnerable surgical patients, many surgeons still shun objective tools. The aim of this position paper was to perform a review of the existing literature and to provide recommendations on emergency laparotomy and in frail patients. This position paper was reviewed by an international expert panel composed of 37 experts who were asked to critically revise the manuscript and position statements. The position paper was conducted according to the WSES methodology. We shall present the derived statements upon which a consensus was reached, specifying the quality of the supporting evidence and suggesting future research directions.
Publisher
Springer Science and Business Media LLC
Subject
Emergency Medicine,Surgery
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