Increasing numbers of older people are undergoing surgery with benefits including symptom relief and extended longevity. Despite these benefits, older people are more likely than younger patients to experience postoperative complications, which are predominantly medical as opposed to surgical. Comprehensive Geriatric Assessment and optimisation offers a systematic approach to risk assessment and risk modification in the perioperative period. Clinical evidence shows that Comprehensive Geriatric Assessment and optimisation reduces postoperative medical complications and is cost effective in the perioperative setting. These benefits have been observed in patients undergoing elective and emergency surgery. Challenges in the implementation of perioperative Comprehensive Geriatric Assessment and optimisation services are acknowledged. These include the necessary involvement of a wide stakeholder group, limited available geriatric medicine workforce and ensuring fidelity to Comprehensive Geriatric Assessment methodology with adaptation to the local context. Addressing these challenges needs a cross-specialty, interdisciplinary approach underpinned by evidence-based medicine and implementation science with upskilling to facilitate innovative use of the extended workforce. Future delivery of quality patient-centred perioperative care requires proactive engagement with national audit, collaborative guidelines and establishment of networks to share best practice.

中文翻译：

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老年人的围手术期护理

越来越多的老年人正在接受手术，其好处包括缓解症状和延长寿命。尽管有这些好处，但老年人比年轻患者更容易出现术后并发症，这些并发症主要是内科并发症而不是外科手术。综合老年评估和优化为围手术期的风险评估和风险修正提供了系统的方法。临床证据表明，综合老年评估和优化可减少术后并发症，并且在围手术期具有成本效益。这些益处已在接受择期手术和急诊手术的患者中观察到。承认实施围手术期综合老年评估和优化服务的挑战。其中包括广泛的利益相关者群体的必要参与、有限的可用老年医学劳动力以及确保忠实于综合老年评估方法并适应当地情况。应对这些挑战需要一种跨专业、跨学科的方法，以循证医学和实施科学为基础，并提高技能，以促进对扩展劳动力的创新使用。未来提供以患者为中心的优质围手术期护理需要积极参与国家审计、协作指南和建立网络以共享最佳实践。应对这些挑战需要一种跨专业、跨学科的方法，以循证医学和实施科学为基础，并提高技能，以促进对扩展劳动力的创新使用。未来提供以患者为中心的优质围手术期护理需要积极参与国家审计、协作指南和建立网络以共享最佳实践。应对这些挑战需要一种跨专业、跨学科的方法，以循证医学和实施科学为基础，并提高技能，以促进对扩展劳动力的创新使用。未来提供以患者为中心的优质围手术期护理需要积极参与国家审计、协作指南和建立网络以共享最佳实践。