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dc.contributor.authorAitken, R
dc.contributor.authorHarun, N-S
dc.contributor.authorMaier, AB
dc.date.accessioned2020-11-26T23:05:00Z
dc.date.available2020-11-26T23:05:00Z
dc.date.issued2020-07-01
dc.identifierpii: 10.1007/s11739-020-02415-y
dc.identifier.citationAitken, R., Harun, N. -S. & Maier, A. B. (2020). Which preoperative screening tool should be applied to older patients undergoing elective surgery to predict short-term postoperative outcomes? Lessons from systematic reviews, meta-analyses and guidelines. INTERNAL AND EMERGENCY MEDICINE, 16 (1), pp.37-48. https://doi.org/10.1007/s11739-020-02415-y.
dc.identifier.issn1828-0447
dc.identifier.urihttp://hdl.handle.net/11343/252100
dc.description.abstractBACKGROUND: Older surgical patients have a higher risk of postoperative mortality and morbidity compared to younger patients. Timely identification of high-risk patients facilitates comprehensive preoperative evaluation, optimization, and resource allocation to help reduce this risk. This review aims to identify a preoperative screening tool for older patients undergoing elective surgery predictive of poor short-term postoperative outcomes. METHODS: A scoping review was conducted. An Ovid MEDLINE search was used to identify systematic reviews or meta-analyses comprising older elective patients in at least two different surgical settings. International guidelines were reviewed for recommendations regarding preoperative tools in this population. RESULTS: Over 50 screening tools were identified. The majority showed a positive association with short-term postoperative mortality and morbidity in older patients. The most commonly described tools were the American Society of Anesthesiologists Physical Status (ASA-PS), frailty tools and domain-specific tools administered as part of comprehensive geriatric assessment (CGA). Due to heterogeneity in outcome measures and statistical methodology the predictive capacity between tools could not be compared. International guidelines described a comprehensive preoperative approach incorporating domain-specific tools rather than recommending a screening tool. CONCLUSION: Multiple tools were associated with poor short-term postoperative outcomes in older elective surgical patients. No single superior tool could be identified. Frailty, cognitive and/or functional tools were most frequently utilized.
dc.languageEnglish
dc.publisherSPRINGER-VERLAG ITALIA SRL
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleWhich preoperative screening tool should be applied to older patients undergoing elective surgery to predict short-term postoperative outcomes? Lessons from systematic reviews, meta-analyses and guidelines
dc.typeJournal Article
dc.identifier.doi10.1007/s11739-020-02415-y
melbourne.affiliation.departmentMedicine (RMH)
melbourne.affiliation.facultyMedicine, Dentistry & Health Sciences
melbourne.source.titleInternal and Emergency Medicine
melbourne.source.volume16
melbourne.source.issue1
melbourne.source.pages37-48
dc.rights.licenseCC BY
melbourne.elementsid1455111
melbourne.contributor.authorMaier, Andrea
dc.identifier.eissn1970-9366
melbourne.accessrightsOpen Access


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