Modification of preoperative preparation as a guarantee of improvement of perioperative treatment in elderly and senile patients

Abstract

Objective. Estimation of the changes efficacy in preoperative preparation of elderly and senile patients as a guarantee for improvement of treatment in perioperative period. Materials and methods. Into the investigation were included 153 patients, suffering an acute cholecystitis on background of biliary calculous disease. Into the control group 89 (58.2 %) patients were included, who were treated in accordance to the standards and clinical protocols, while into the main one - 64 (41.8%) patients, in whom preoperative preparation was modified in accordance to algorithm. Results. The patients’ state in admittance to the hospital in a control group was scored in (30.8 ± 5.2) points, and in the main - in (31.6 ± 5.7) points (U = 2684.00, p =0.5437). All the patients were operated in an urgent order. Application of algorithm of preoperative preparation in elderly and senile patients was followed by improvement in their general state in early postoperative period, estimated in accordance to the P-POSSUM scale: in the main group this index have constituted (28.2 ± 4.6) points, and in a control one - (31.1 ± 7.8) points (U = 2219.00, p = 0.0201). As well, the reduction of duration of the artificial pulmonary ventilation was guaranteed: in a control group - 80.00 (70.00; 120.00) min, while in the main one – 63.00 (52.50; 75.00) min (U = 1316, p < 0.0001). Conclusion. Modified preoperative preparation, more frequent performance of miniinvasive operative interventions and eale activisation of the patients have shortened in them a stationary stay: to (10.9 ± 2.5) days in a control group, while (8.3± 2.3) days – in the main one (U = 1745.50, p < 0.0001).

Keywords

• an acute cholecystitis
• cholecystectomy
• elderly and senile patients
• algorithm