Preoperative assessment and optimization of cognitive dysfunction and frailty in the ambulatory surgical patient

Charipova Karina; Urits Ivan; Viswanath Omar; Urman Richard D.

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Preoperative assessment and optimization of cognitive dysfunction and frailty in the ambulatory surgical patient

机译：手术患者认知功能障碍和脆弱的术前评估和优化

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Purpose of review The number and the complexity of procedures taking place at ambulatory surgery centers is steadily increasing. The rate at which medically complex patients, including those with baseline neurocognitive disorders, are undergoing ambulatory procedures is seeing a concurrent rise. Given the significant physical and psychological stress associated with surgery even in the ambulatory setting, it is essential to evaluate the ability of a patient to acclimate to stressful triggers in order to assess risk of subpar medical outcomes and increased mortality. In this review, we discuss recent advances in the assessment of both cognition and frailty and describe the implementation of these tools in the ambulatory surgery setting. Recent findings Recent Society for Perioperative Assessment and Quality Improvement (SPAQI) recommendations for evaluating at-risk patients focus on a two-pronged approach that encompasses screening for both impaired cognition and frailty. Screening should ideally occur as early as possible, but tools such as the Mini-Cog examination and FRAIL Questionnaire are efficient and effective even when used the day of surgery in high-risk patients. The recognition of at-risk patients using standardized screening and the use of this assessment to guide perioperative monitoring and interventions is essential for optimizing outcomes for the complex ambulatory surgery patient.

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来源
《Current opinion in anaesthesiology》 |2020年第6期|共8页
作者
Charipova Karina; Urits Ivan; Viswanath Omar; Urman Richard D.;
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作者单位

Georgetown Univ Sch Med Washington DC USA;

Harvard Med Sch Beth Israel Deaconess Med Ctr Boston MA 02115 USA;

Univ Arizona Coll Med Phoenix Valley Anesthesiol &

Pain Consultants Envis Phys Phoenix AZ USA;

Brigham &

Womens Hosp Dept Anesthesiol Perioperat &

Pain Med 75 Francis St Boston MA 02115 USA;

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原文格式 PDF
正文语种 eng
中图分类麻醉学;
关键词
ambulatory; cognitive impairment; evaluation; frailty; outcomes; outpatient;

机译：守护者;认知障碍;评估;脆弱;结果;门诊;

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2. Frailty Syndrome Prevalence and Its Correlation with Cognitive Function in Elderly Surgical Inpatients [J] . Feifan Liu, Yanling Heng, Qianwen Li, 生物科学与医学（英文） . 2020,第010期
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机译：老年外科病人的术前认知和虚弱筛查：叙事回顾。
5. Preoperative Frailty Assessment, Operative Severity Score, and Early Postoperative Loss of Independence in Surgical Patients Age 65 Years or Older Invited Commentary [J] . Galandiuk Susan Journal of the American College of Surgeons . 2021,第4期

机译：术前脆弱的评估，手术严重程度得分，并在65岁或以上的手术患者中的独立性早期丧失休息
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机译：术前脆弱的评估，手术严重程度得分，并且在65岁或以上的手术患者中的独立性早期丧失
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机译：手术患者认知避税机制的术前焦虑术前焦虑的调节
8. The relationship of preoperative teaching received, preoperative teaching valued, and selected conditioning factors to postoperative recovery in ambulatory laparoscopic abdominal surgery patients. [D] . Poole, Ellen Louise Benge. 2007

机译：动态腹腔镜腹部手术患者术前接受的教学，术前教学的重视和选择的条件因素与术后恢复的关系。
9. Preoperative cognitive and frailty screening in the geriatric surgical patient: A narrative review [O] . Michael S. Axley, Katie J. Schenning -1

机译：老年手术患者的术前认知和虚弱筛查：叙述性回顾
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11. Medicare and Beneficiaries Could Save Billions If CMS Reduces Hospital Outpatient Department Payment Rates for Ambulatory Surgical Center-Approved Procedures to Ambulatory Surgical Center Payment Rates [R] . 2014

机译：医疗保险和受益人可以节省数十亿如果Cms减少门诊手术中心批准的门诊部门支付率到门诊手术中心支付率

Preoperative assessment and optimization of cognitive dysfunction and frailty in the ambulatory surgical patient

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