Preoperative assessment and optimization of cognitive dysfunction and frailty in the ambulatory surgical patient

PURPOSE OF REVIEW: The number and the complexity of procedures taking place at ambulatory surgery centers is steadily increasing. The rate at which medically complex patients, including those with baseline neurocognitive disorders, are undergoing ambulatory procedures is seeing a concurrent rise. Given the significant physical and psychological stress associated with surgery even in the ambulatory setting, it is essential to evaluate the ability of a patient to acclimate to stressful triggers in order to assess risk of subpar medical outcomes and increased mortality. In this review, we discuss recent advances in the assessment of both cognition and frailty and describe the implementation of these tools in the ambulatory surgery setting.

RECENT FINDINGS: Recent Society for Perioperative Assessment and Quality Improvement (SPAQI) recommendations for evaluating at-risk patients focus on a two-pronged approach that encompasses screening for both impaired cognition and frailty. Screening should ideally occur as early as possible, but tools such as the Mini-Cog examination and FRAIL Questionnaire are efficient and effective even when used the day of surgery in high-risk patients.

SUMMARY: The recognition of at-risk patients using standardized screening and the use of this assessment to guide perioperative monitoring and interventions is essential for optimizing outcomes for the complex ambulatory surgery patient.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:33

Enthalten in:

Current opinion in anaesthesiology - 33(2020), 6 vom: 01. Dez., Seite 732-739

Sprache:

Englisch

Beteiligte Personen:

Charipova, Karina [VerfasserIn]
Urits, Ivan [VerfasserIn]
Viswanath, Omar [VerfasserIn]
Urman, Richard D [VerfasserIn]

Links:

Volltext

Themen:

Journal Article
Review

Anmerkungen:

Date Completed 16.11.2020

Date Revised 02.02.2024

published: Print

Citation Status MEDLINE

doi:

10.1097/ACO.0000000000000901

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM313447446