Common themes in geriatric emergency general surgery: a narrative review
Submitted: January 8, 2024
Accepted: May 21, 2024
Published: June 25, 2024
Accepted: May 21, 2024
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Population aging is a growing phenomenon. The geriatric patient is defined by physical, psychological, and social characteristics associated with aging that make him or her more fragile and susceptible. An older patient is usually fragile: frailty has a linear, if not unambiguous, relationship with age. With this background, the concept of futility emerges in emergency surgery, which refers to having a goal but being almost certain of failure in achieving it. A narrative review of the literature was carried out using PubMed, Google Scholar, and Cochrane to identify pertinent publications. Inclusion criteria included: i) an emergency setting in geriatric general surgery, ii) frailty in emergency surgery, and iii) futility in emergency surgery. The study identified valid assessment scores for older and frail patients, as well as imaging tools that may aid in the evaluation of frailty, demonstrating the potential futility of surgical treatment. The review addressed the most common acute surgical situations that affect geriatric patients. Older patients are more fragile and vulnerable than the general population, even though geriatric age does not always correlate with frailty. Several fragility scores have been developed to perform an accurate preoperative assessment of the urgent elderly surgical patient, to estimate treatment futility and perioperative risk, and to guide the surgeon to the most appropriate therapeutic or palliative action.
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Santandrea, G., Vallicelli, C., Carcoforo, P., Agnoletti, V., Bravi, F., & Catena, F. (2024). Common themes in geriatric emergency general surgery: a narrative review. Surgery in Geriatrics and Frailty, 1(1). Retrieved from https://www.sigaf.eu/site/article/view/11
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