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Mini-Review

Nutzen altersmedizinischer Abklärungen vor Operationen, Interventionen und onkologischen Therapien

Published Online:April 12, 2023https://doi.org/10.1024/1661-8157/a004050

Abstract

Zusammenfassung: Ältere und hochbetagte Patient_innen haben ein erhöhtes Risiko für Komplikationen und nachteilige Behandlungsverläufe bei Operationen, Interventionen und onkologischen Therapien. Gleichzeitig sollte diese Gruppe nicht anhand des chronologischen Alters von potenziell nutzenbringenden medizinischen Verfahren per se ausgeschlossen werden. Geriatrische Syndrome und erhöhte Vulnerabilität durch eine altersmedizinische Abklärung rechtzeitig zu identifizieren wird zunehmend wichtiger und wird in den Richtlinien der Fachgesellschaften mehrerer Spezialdisziplinen bereits heute empfohlen. Nach einer geriatrischen Abklärung sollte jedoch idealerweise ein proaktives Co-Management im Sinn einer integrierten Versorgung erfolgen. Die Etablierung von interdisziplinären Behandlungspfaden für ältere Spitalpatient_innen kann dazu beitragen, Behandlungsergebnisse signifikant zu verbessern. Dieser Ansatz kann neben verbesserten patientenbezogenen Ergebnissen und ansteigenden Qualitätsindikatoren auch positive gesundheitsökonomische Effekte bieten.


Benefit of a Geriatric Evaluation before Operations, Interventions and Oncological Therapies

Abstract: Older patients face an increased risk of complications and adverse outcomes during and after operations, interventions, and intense oncological therapies. At the same time, this patient group should not be excluded per se from potentially beneficial medical procedures based on chronological age alone. The timely identification of geriatric syndromes and increased vulnerability by means of comprehensive geriatric assessment is becoming increasingly important and is already recommended in the guidelines of professional societies of several medical disciplines. Nonetheless, the geriatric assessment should ideally be followed by proactive co-management in the sense of integrated care. The establishment of interdisciplinary and integrated care pathways for older hospital patients can contribute to significantly improved treatment outcomes. In addition to better patient-related outcomes and rising quality indicators, this approach may also offer positive health economic effects.


Bénéfice d’une évaluation gériatrique avant les opérations, interventions et thérapies oncologiques

Résumé: Les patients âgés sont confrontés à un risque accru de complications et d’effets indésirables pendant et après des opérations, des interventions et des thérapies oncologiques intenses. Dans le même temps, ce groupe de patients ne doit pas être exclu en soi de procédures médicales potentiellement bénéfiques en raison de son seul âge chronologique. L’identification en temps utile des syndromes gériatriques et de la vulnérabilité accrue au moyen d’une évaluation gériatrique complète revêt une importance croissante et est déjà recommandée dans les directives des sociétés professionnelles de plusieurs disciplines médicales. Cependant, l’évaluation gériatrique devrait idéalement être suivie d’une cogestion proactive dans le sens de soins intégrés. La mise en place de parcours de soins interdisciplinaires et intégrés pour les patients âgés hospitalisés peut contribuer à améliorer considérablement les résultats des traitements. Outre de meilleurs résultats liés aux patients et des indicateurs de qualité en hausse, cette approche peut également avoir des effets positifs sur l’économie de la santé.

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