Please use this identifier to cite or link to this item: https://doi.org/10.1007/s11739-020-02415-y
Title: 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
Authors: Aitken, Rachel
Harun, Nur-Shirin
Maier, Andrea Britta 
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
Geriatric assessment
Aged
Screening tool
Preoperative care
Surgery
Frailty
PERIOPERATIVE MANAGEMENT
AMERICAN-COLLEGE
SURGICAL-PATIENT
FRAILTY SYNDROME
RISK-FACTORS
IMPACT
MORTALITY
DELIRIUM
PEOPLE
CLASSIFICATION
Issue Date: 1-Jul-2020
Publisher: SPRINGER-VERLAG ITALIA SRL
Citation: Aitken, Rachel, Harun, Nur-Shirin, Maier, Andrea Britta (2020-07-01). 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) : 37-48. ScholarBank@NUS Repository. https://doi.org/10.1007/s11739-020-02415-y
Abstract: Background: 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.
Source Title: INTERNAL AND EMERGENCY MEDICINE
URI: https://scholarbank.nus.edu.sg/handle/10635/234901
ISSN: 1828-0447
1970-9366
DOI: 10.1007/s11739-020-02415-y
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