Perioperative Evaluation and Management of Frailty Among Older Adults Undergoing Colorectal Surgery
Publication Date: March 29, 2022
Last Updated: March 31, 2022
Summary of Recommendations
Treatment recommendations regarding colorectal surgery should consider patients’ degree of frailty (ie, physiological age) rather than chronological age. (1A)
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Frailty screening in the ambulatory setting identifies vulnerable and frail older adults. (1A)
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Treatment plans for frail older adults should align with patients’ goals of care and should be based on a discussion regarding realistic outcomes. (1C)
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Cognitive function should be assessed preoperatively in frail older adults. (1C)
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Frail older adults should be screened for postoperative signs and symptoms of delirium and treated appropriately. (1B)
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Frail older adults may benefit from preoperative, multimodality optimization (ie, prehabilitation). (1B)
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Frail patients may benefit from a multidisciplinary approach to perioperative care that includes a health care provider with geriatric expertise. (1C)
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Frail older adults should be screened for social vulnerabilities and offered support. (1C)
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Frail older adults should be managed with enhanced recovery protocols after surgery with modifications, as needed. (1A)
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Minimally invasive techniques should be considered for frail older adults undergoing colorectal surgery. (1B)
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In older adults, patient-centered postoperative functional outcomes should be considered in addition to traditional postsurgical outcomes. (1B)
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Title
Perioperative Evaluation and Management of Frailty Among Older Adults Undergoing Colorectal Surgery
Authoring Organization
American Society of Colon and Rectal Surgeons
Publication Month/Year
March 29, 2022
Last Updated Month/Year
February 12, 2024
Country of Publication
US
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Ambulatory, Outpatient, Operating and recovery room
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Management
Diseases/Conditions (MeSH)
D003107 - Colorectal Surgery, D019990 - Perioperative Care
Keywords
perioperative care, Colorectal Surgery, perioperative management
Source Citation
Saur NM, Davis BR, Montroni I, Shahrokni A, Rostoft S, Russell MM, Mohile SG, Suwanabol PA, Lightner AL, Poylin V, Paquette IM, Feingold DL; Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Perioperative Evaluation and Management of Frailty Among Older Adults Undergoing Colorectal Surgery. Dis Colon Rectum. 2022 Apr 1;65(4):473-488. doi: 10.1097/DCR.0000000000002410. PMID: 35001046.
Methodology
Number of Source Documents
166
Literature Search Start Date
January 1, 2014
Literature Search End Date
November 24, 2021