Authors: Dr. Sara Pervaiz, Dr. Madeha Gohar Dr. Santosh Kumar, Dr. Zaka Ullah, Dr. FNU Bhawana, Dr. Saoud Javed
ABSTRACT: As more and more older patients are receiving complex surgery, effective optimization of the perioperative period is important. There is decreased cardiovascular and pulmonary reserve, history of frailty and a higher risk of post-operative complications with aging. This systematic review and meta-analysis examines the effect of perioperative cardiac and pulmonary optimization interventions in seniors patients on surgical outcomes. The relevant studies will be identified using the major electronic databases, such as PubMed/MEDLINE, Embase, Scopus, Web of Science and Cochrane Library according to PRISMA 2020 guidelines. Assessed outcomes will be postoperative cardiac events, pulmonary complications, intensive care admission, length of hospital stay, mortality and functional recovery. Existing data show there is a potential role for cardiovascular risk assessment, hemodynamic optimization, pulmonary rehabilitation, inspiratory muscle training and multimodal prehabilitation in improving postoperative outcomes. High quality studies are still needed to develop standardised approaches to optimise surgery’s safety and recovery for elderly surgical patients, while individual multidisciplinary optimisation programmes could work.
Keywords: Elderly patients; perioperative optimization; cardiac risk assessment; pulmonary rehabilitation; prehabilitation; postoperative complications; major surgery; enhanced recovery; meta-analysis; surgical outcomes.