Management of Frailty and its Challenges in Geriatric Patients on General Abdominal Anesthesia.

Abstract

Introduction: In that material, we are doing to informed for frailty, how we can measure it, surgical outcome and its management from the anesthesiologist. Frailty is a condition of decreased physiological reserves that often increases with increasing age and decided in adverse outcomes. Frailty in elderly surgical patients may be varied from 25,5 -56.1% and is a strong predictor for surgical outcomes. The anesthetist needs to predict how a geriatric patient will tolerate the stress of surgery and to do what is necessary to protect and save elderly lives. In Albania, there are almost 439 000 elderly people in 2021 and suspect to 626 000 in 2051. According to the WHO, 1 in 25 persons performed surgery, so the number of geriatric patients that done surgery will be very high. According to deficits’ in function, mobility, cognition, chronic diseases, and geriatric syndromes we can use the clinical frailty scale, the Edmonton Frailty Scale, or frailty index for calculation of frailty. We need frailty patients to evaluated preoperative risk-classification, intra-operative care, management of general anesthesia, early immobilization as well as treatment of postoperative delirium because frailty increased intra-operative morbidity, increased postoperative complications especially delirium, extends hospitalization, non – home discharge, and mortality. Anesthesiologists would be always aware to prepare the geriatric patients for surgery, to maintain the intra-operative functional reserve of frailty patients, to manage perfect anesthesia, to realized early mobilization, and discharge back home. Conclusion: Many geriatric patients have multi-organ problems. Frailty is a practical, unifying concept in the care of these older people that directs attention away from organ-specific diagnoses towards a more holistic viewpoint of the patient and their medical medicament. All geriatric patients need to screen for frailty.

Keywords

• Clinical frailty scale
• delirium
• frailty syndrome
• frailty index
• general anesthesia