Optimal preoperative assessment of the geriatric patient

The population of the United States is growing and aging. The U.S. Census Bureau projects the number of Americans age 65 years and older will more than double between 2010 and 2050. In recent years, the National Hospital Discharge Survey has demonstrated increasing hospital utilization by elderly persons. As this segment of the population continues to age, it will place greater demands on surgical services. It is imperative that strategies are developed to meet these growing requirements and to ensure higher-quality care for geriatric surgical patients. To support these efforts, several primary methods aimed at incorporating geriatric principles into mainstream surgical care have been attempted, including the development of quality indicators, physician competencies, and best practice guidelines. The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) and the American Geriatric Society (AGS) recently collaborated on a series of practice guidelines focused on optimal care of elderly surgical patients. The ACS NSQIP/AGS Best Practice Guidelines, a compilation of the most current and evidence-based recommendations for improving the perioperative care of this vulnerable population, is summarized in this article.