The geriatric patient: special aspects of peri-operative management

Overview

This 2019 instructional lecture in EFORT Open Reviews by Wirtz and Kohlhof offers a German perspective on orthopaedic care for older adults in higher-income countries. Starting from demographic change and the growing share of hospital admissions and musculoskeletal operations in older people, it argues that geriatric patients need care models built around their specific needs.

Who it is for

Orthopaedic and trauma surgeons, anaesthetists, geriatricians, rehabilitation specialists and nursing teams caring for older adults undergoing surgery.

Key areas covered

The lecture describes how ageing affects nearly every organ system, including skin fragility with a higher risk of pressure sores and cognitive changes that can slow rehabilitation. It outlines what older patients, especially those with co-morbidities, need across the pre-, peri- and post-operative periods. This includes documenting the patient's goals and treatment preferences, following fasting recommendations and planning individualised physical activity and rehabilitation.

Notable emphasis

The authors highlight patient blood management principles as one of the measures that improve outcomes in this group. They call for new interdisciplinary models of care that bring geriatric and orthopaedic specialists together, rather than treating older patients within standard pathways.

How to use this guideline

The article is a practical overview grounded in the German health system. Readers should consult the full text for the recommended measures in each phase of care and adapt them to local services.