Ann Acad Med Singap
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As the world's population ages rapidly, many elderly people are living to a much more advanced age than before. Consequently, medical conditions that require surgical interventions such as solid organ cancers are also getting more common. While young and fit patients may be able to withstand surgical stresses and recover rapidly after operation, older adults may find these challenging. ⋯ However, recent studies have shown that prehabilitation may be more effective in bringing the fitness level of elderly patients to a higher level before they go for surgery. There are many controversies regarding the effectiveness of prehabilitation, the components of this intervention-be it mono- or multimodalities-and the duration of prehabilitation. This paper looks at the current evidence of this hot topic revolving geriatric surgery.
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Global demographic changes have resulted in an older, frailer surgical population with significant multimorbidity causing higher frequency of adverse postoperative outcomes. The need for restructuring of perioperative care pathways to address this issue has been recognised. Comprehensive geriatric assessment (CGA) and optimisation are emerging as innovative perioperative pathways. ⋯ Similar models are being established in Singapore in hip fracture, colorectal and vascular populations. The challenges in the widespread adoption of such models of care are similar across settings. The global nature of translation is also discussed in this paper.
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Ann Acad Med Singap · Nov 2019
The Changing Epidemiology of Serious Trauma in the Elderly Population: An Increasing Concern of a Tertiary Hospital in Singapore.
Although trauma is often seen in the young, there is a recent shift in this trend as more elderly patients are hospitalised for traumatic injuries. This study examined serious trauma in young and elderly patients and hypothesised that the increase in incidence of elderly serious trauma has led to greater burden of care in hospitals and health services. ⋯ The number of elderly trauma patients were thrice that of all trauma patients seen and they also required longer hospitalisation. This trend has led to greater burden of care in hospitals and health services in Singapore.
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Ann Acad Med Singap · Nov 2019
Outcome of Enhanced Recovery After Surgery (ERAS) for Colorectal Surgery in Early Elderly and Late Elderly Patients.
This study aimed to determine the outcome of enhanced recovery after surgery (ERAS) programme in elderly colorectal surgery patients. ⋯ ERAS is a safe and effective protocol that can be used in EE and LE colorectal surgery patients.
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Sarcopenia is a condition in which patients have an abnormally low muscle mass with poor muscle function. It is prevalent in older patients and is often associated with frailty. It has gained increasing recognition as a significant indicator of poor surgical outcomes. ⋯ We also discuss the diagnosis of sarcopenia in terms of muscle mass and muscle function and common definitions of both terms. An overview of the impact of sarcopenia on different surgical specialties is reviewed. Lastly, a survey of current treatments available for sarcopenia and their limited impact are discussed with a view to encouraging possible future studies.