老年手术患者的最佳术前评估

The population of the United States (US) is growing and aging. The US Census Bureau projects that the number of Americans age 65 years and older will more than double between 2010 and 2050. The percentage of Americans 65 and older will grow from 13% to more than 20% of the total population by 2030, and the fastest growing segment of this group (individuals 85 years and older) is expected to triple in number over the next 4 decades. These changes in the age demographics of the US population are largely due to people living longer and the “baby boomer” generation crossing into the 65 and older age bracket in 2011. How will this demographic change affect the health care system?

The National Hospital Discharge Survey has demonstrated increasing hospital utilization by elderly persons. In 1970, individuals 65 and older represented 10% of the population, and they accounted for 20% of hospital discharges and 33% of the days of care. By 2007, the percentage of persons 65 and older grew modestly to 13%, yet their hospital use increased drastically to 37% of hospital discharges and 43% of the days of care. The older individuals have significantly higher rates per population of both inpatient and outpatient surgical and nonsurgical procedures compared with other age groups. In 2006, elderly patients underwent 35.3% of inpatient procedures and 32.1% of outpatient procedures. As the population of the US continues to age, it will place greater demands on surgical services. It is imperative that strategies are developed to meet these growing demands and to ensure higher quality care for geriatric surgical patients.

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