Geriatric surgical patients: is it possible to implement the comprehensive geriatric assessment in the emergency setting?

Abstract

With changing world demographics, increasing numbers of older patients present with complex surgical diseases and will require surgical management, mainly in the emergency setting.Ageing is associated with multimorbidity and frailty, both of which are independent predictors of adverse outcomes.Screening surgical patients for frailty, using specific tools, can lead to targeted interventions that reduce perioperative complications and length of hospital stay.In the last 10 years, perioperative models of care incorporating Comprehensive Geriatric Assessment and optimisation methodology have been implemented for elective surgical procedures.In the emergency setting, surgeons are required to make critical, time-sensitive decisions, often with limited information and high responsibility. A comprehensive geriatric multidisciplinary assessment could support them in practice to improve the management of geriatric surgical patients.We aim to report the last evidence about the comprehensive geriatric assessment for geriatric surgical patients, including its implementation in the emergency setting through a focused narrative review.Graphical