Urological-Geriatric Integrated Diagnostic-Therapeutic Pathway for elderly patients with urologic diseases

Abstract

Aging of population represents a new challenge for physicians who have to deal with the balance of risk and benefit in a population that is poorly represented in clinical trials. Frail patients need individualized treatments because of their high risk of developing complications in the course of therapies. Several studies have reported the effect of frailty on falls, hospitalization and mortality, but only few have focused on surgical patients and frailty is not included in the traditional surgical risk scales. Geriatric surgery patients have a physiologic vulnerability requiring assessment beyond the traditional preoperative evaluation of adults. Although single organ evaluation cannot be ignored in elderly population, recognition of frail patients during preoperative assessment may provide additional insight in predicting poor outcome; thus, aiding preoperative decision-making. We developed a Urological-Geriatric Integrated Diagnostic-Therapeutic Pathway in order to evaluate ≥65 years old patients affected by urogenital pathologies which require major surgery and to early identify frail subject.

Keywords

• Elderly
• urologic surgery
• multidimensional prognostic index
• frailty
• decision making.