Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Frailty has no single universally accepted definition or method for assessment. It is commonly defined from a physiological perspective as a disruption of homeostatic mechanisms ultimately leading to a vulnerable state. Numerous scoring indices and assessments exist to assist clinicians in determining the frailty status of a patient. The purpose of this review is to discuss the relationship between frailty and perioperative outcomes in surgical patients. ⋯ Patients undergoing surgery who are deemed frail, regardless of the scoring assessment used, have a higher likelihood of experiencing adverse perioperative outcomes. With the lack of a unified definition for frailty, further research is needed to address which assessment method is most predictive of adverse postoperative outcomes.
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Review Case Reports
Prevention of venous thromboembolism in the Enhanced Recovery After Surgery (ERAS) setting: an evidence-based review.
To review the evidence surrounding appropriate prophylaxis for venous thromboembolism (VTE) in patients undergoing surgery. ⋯ Venous thromboembolism is a serious but preventable complication of hospitalization, especially among surgical patients. Historically, it has accounted for a high burden of postoperative morbidity and mortality. In the Enhanced Recovery After Surgery era, our aim should be no less ambitious than the eradication of postoperative VTE.
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Review
What outcomes are important in the assessment of Enhanced Recovery After Surgery (ERAS) pathways?
The purpose of this narrative review is to provide a framework from which to measure the outcomes of Enhanced Recovery After Surgery (ERAS) programs. ⋯ Recovery after surgery is a complex construct. Different outcomes are important at different phases along the recovery trajectory. Measures for quantifying recovery in hospital and after discharge are available. A consensus-based core set of outcomes with input from multiple stakeholders would facilitate research reporting.
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Review
Cardiopulmonary exercise testing, prehabilitation, and Enhanced Recovery After Surgery (ERAS).
This review evaluates the current and future role of cardiopulmonary exercise testing (CPET) in the context of Enhanced Recovery After Surgery (ERAS) programs. ⋯ Perioperative CPET is finding an increasing spectrum of roles, including risk evaluation, collaborative decision-making, personalized care, monitoring interventions, and guiding prescription of prehabilitation. These indications are potentially of importance to patients having surgery within an ERAS program, but there are currently few publications specific to CPET in the context of ERAS programs.