• Paola Aceto, Antonelli Incalzi Raffaele R Policlinico Universitario Campus Biomedico, Rome, Italy., Gabriella Bettelli, Michele Carron, Fernando Chiumiento, Antonio Corcione, Antonio Crucitti, Stefania Maggi, Marco Montorsi, Maria Caterina Pace, Flavia Petrini, Concezione Tommasino, Marco Trabucchi, Stefano Volpato, and Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI), Società Italiana di Gerontologia e Geriatria (SIGG), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia Geriatrica (SICG) and Associazione Italiana di Psic.
• Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
• Aging Clin Exp Res. 2020 Sep 1; 32 (9): 1647-1673.

BackgroundSurgical outcomes in geriatric patients may be complicated by factors such as multiple comorbidities, low functional performance, frailty, reduced homeostatic capacity, and cognitive impairment. An integrated multidisciplinary approach to management is, therefore, essential in this population, but at present, the use of such an approach is uncommon. The Perioperative Management of Elderly patients (PriME) project has been established to address this issue.AimsTo develop evidence-based recommendations for the integrated care of geriatric surgical patients.MethodsA 14-member Expert Task Force of surgeons, anesthetists, and geriatricians was established to develop evidence-based recommendations for the pre-, intra-, and postoperative care of hospitalized older patients (≥ 65 years) undergoing elective surgery. A modified Delphi approach was used to achieve consensus, and the strength of recommendations and quality of evidence was rated using the U.S. Preventative Services Task Force criteria.ResultsA total of 81 recommendations were proposed, covering preoperative evaluation and care (30 items), intraoperative management (19 items), and postoperative care and discharge (32 items).ConclusionsThese recommendations should facilitate the multidisciplinary management of older surgical patients, integrating the expertise of the surgeon, the anesthetist, the geriatrician, and other specialists and health care professionals (where available) as needed. These roles may vary according to the phase and setting of care and the patient's conditions.

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