Designed and created by Guideline Central in participation with the American Society of Colon and Rectal Surgeons
Perioperative Evaluation and Management of Frailty Among Older Adults Undergoing Colorectal Surgery
Patient Guideline Summary
Publication Date: March 29, 2022
Last Updated: March 3, 2023
Objective
Objective
This patient summary means to discuss key recommendations from the American Society of Colon and Rectal Surgeons (ASCRS) for the perioperative evaluation and management of frailty among older adults undergoing colorectal surgery. It is limited to adults 18 years of age and older and should not be used as a reference for children.
Overview
Overview
- Older and chronically ill patients are at increased risk for complications from surgery. Optimal management seeks to minimize that risk.
- This patient summary focuses on the management of frail patients before, during, and after surgery.
Diagnosis
Diagnosis
- Treatment recommendations regarding colorectal surgery should consider patients’ demonstrated frailty regardless of age through careful frailty screening.
- Treatment plans for frail older adults should align with patients’ goals of care and should be based on a discussion regarding realistic outcomes.
- Cognitive function should be assessed before surgery.
- Frail older adults should be assessed after surgery for signs and symptoms of delirium and treated appropriately.
- Frail older adults may benefit from preoperative, multimodality optimization (i.e., prehabilitation).
- Frail patients may benefit from a multidisciplinary approach to perioperative care that includes a health care provider with geriatric expertise.
- Frail older adults should be screened for social vulnerabilities (problems that could arise while recovering at home) and offered support.
- Frail older adults should be managed with enhanced recovery protocols after surgery.
Treatment
Treatment
- Minimally invasive techniques should be considered for frail older adults undergoing colorectal surgery.
- In older adults, patient-centered postoperative functional outcomes should be considered in addition to traditional postsurgical outcomes.
Abbreviations
- ASCRS: American Society Of Colon And Rectal Surgeons
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.
Disclaimer
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.