Kirurgi på gamla människor måste anpassas efter individen. Åldrandets fysiologi en faktor för operationsresultatet
Sammanfattning
We are facing an unprecedented challenge because of the grey revolution: the number of octa- and nonagenarians will double or even treble within the next 20 years. Already now about one fourth of all surgical procedures are performed on people over 70. Elderly people have an increased risk of complications since all organ functions are diminished compared with a young population. To avoid devastating complications, indications must be carefully considered together with patients and relatives. Modern anethesiological methods, minimally invasive techniques and proactive modern nursing care can minimize the risk for complications. Neuropsychiatric complications, eg perioperative delirium, make the patient unable to follow instructions and this may spoil the surgical results. Delirium is almost always an effect of a preventable cause, eg, another disease like infection, uncontrolled pain or polypharmacy. We therefore think that specialized geriatric surgical units are necessary to give the oldest old a decent care.