Individuals age 65 and older constitute the fastest growing segment in the U.S. population. This change in demographics will result in a larger number of older patients presenting for medical and surgical therapies.
Elderly patients in need of surgical intervention represent a unique challenge to health care professionals. One concern is the delay in elective surgical procedures seen among geriatric patients. This results in an increased incidence of emergency procedures; elderly patients undergoing emergent surgical procedures have a particularly high associated mortality.
Another important factor includes the consideration of the cognitive and functional status preoperatively and how surgery may impact the quality of life postoperatively. In an effort to optimally address these complexities, the North Shore-Long Island Jewish Health system has implemented a focused approach to analyze all of the factors and interventions that may impact the geriatric surgery patient.
Decision to Operate
It is difficult to find a consensus regarding a patient’s age and expected outcome after surgery. In fact, numerous operations have been performed on patients over 100 years old with good statistical results. This is why every patient’s case has to be decided on an individual basis.
There are age related changes in all the organs of the human body, and this may lead to adverse clinical consequences after a surgical stress. Moreover, elderly patients often have several preexisting medical conditions that negatively impact successful surgical interventions. Nevertheless, with careful consideration to the possible clinical consequences, and by implementing specialized practices that are unique to the elderly patient, surgical intervention can be carried out with good outcomes.
Unique features of the Geriatric Surgery movement at North Shore-LIJ
There are several features unique to the North Shore-LIJ network, which allow us to be leaders in geriatric surgery. One important element is the presence of the largest geriatric trauma experience on Long Island. This practice enhances our expertise in neurosurgery, orthopedic surgery and in the management of the critically injured geriatric patient. Another unique feature is the robust minimally invasive surgery department.
Laparoscopic colon, gastric and esophageal procedures are among the alternatives routinely implemented for the geriatric patient. Most importantly, the exceptional academic environment within the North Shore/LIJ system allows access to an enormous network of medical expertise, working congruently to optimize the care of elderly surgical patients.