Operative risk stratifi cation

Abstract

The preoperative evaluation of the geriatric clearly presents unique challenges. Historically, risk stratification has focused on a single organ system. In the geriatric patient the combined effects of frailty, comorbidity, and disability contribute cumulatively to poor outcomes. Age, cognitive dysfunction, falls, malnutrition, and anemia are all markers for poor outcome in the geriatric patient. After completion of the geriatric workup, a complete picture of the patient’s overall health in all domains will be completed. The combined and cumulative effects of these markers provide a more powerful tool for the prediction of mortality, functional recovery, and institutionalization following surgery.