Challenges in surgical and perioperative care for Brazil's aging population
Andre P. Schmidt, Federico Bilotta
References
1. Instituto Brasileiro de Geografia e Estatística (IBGE). 2022 Census: Number of elderly persons in the Brazilian population grew 57.4% in 12 years. Available at: https://agenciadenoticias.ibge. gov.br/en/agencia-news/2184-news-agency/news/38187- 2022-census-number-of-elderly-persons-in-the-brazilian-population-grew-57-4-in-12-years. Accessed on 2025 Jan 2.
2. Gutierrez CS, Passos SC, Castro SMJ, et al. Few and feasible preoperative variables can identify high-risk surgical patients: derivation and validation of the Ex-Care risk model. Br J Anaesth. 2021;126:525−32.
3. Schmidt AP, Stefani LC. How to identify a high-risk surgical patient? Braz J Anesthesiol. 2022;72:313−5.
4. Stefani LC, Gutierrez CS, Castro SMJ, et al. Derivation and validation of a preoperative risk model for postoperative mortality (SAMPE model): An approach to care stratification. PLoS One. 2017;12:e0187122.
5. Passos SC, de Jezus, Castro SM, Stahlschmidt A, et al. Development and validation of the Ex-Care BR model: a multicentre initiative for identifying Brazilian surgical patients at risk of 30-day in-hospital mortality. Br J Anaesth. 2024;133:125−34.
6. Gong S, Qian D, Riazi S, et al. Association between the FRAIL scale and postoperative complications in older surgical patients: a systematic review and meta-analysis. Anesth Analg. 2023;136:251−61.
7. Becerra-Bolanos ~ A, Hern andez-Aguiar Y, Rodríguez-P erez A. Pre- operative frailty and postoperative complications after noncardiac surgery: a systematic review. J Int Med Res. 2024; 52:3000605241274553.
8. Lin HS, Watts JN, Peel NM, Hubbard RE. Frailty and postoperative outcomes in older surgical patients: a systematic review. BMC Geriatr. 2016;16:157.
9. Taylor J, Robledo KP, Medel V, et al. Association between surgical admissions, cognition, and neurodegeneration in older people: a population-based study from the UK Biobank. Lancet Healthy Longev. 2024;5:100623.
10. Mevorach L, Forookhi A, Farcomeni A, Romagnoli S, Bilotta F. Perioperative risk factors associated with increased incidence of postoperative delirium: systematic review, meta-analysis, and Grading of Recommendations Assessment, Development, and Evaluation system report of clinical literature. Br J Anaesth. 2023;130:e254−62.
11. Crisan I, Slankamenac K, Bilotta F. How much does it cost to be ¸ fit for operation? The economics of prehabilitation. Curr Opin Anaesthesiol. 2024;37:171−6.
12. Mohanty S, Rosenthal RA, Russell MM, Neuman MD, Ko CY, Esnaola NF. Optimal perioperative management of the geriatric patient: A best practices guideline from the American College of Surgeons NSQIP and the American Geriatrics Society. J Am Coll Surg. 2016;222:930−47.
13. Kumar C, Salzman B, Colburn JL. Preoperative assessment in older adults: a comprehensive approach. Am Fam Physician. 2018;98:214−20.
14. Wolfe JD, Wolfe NK, Rich MW. Perioperative care of the geriatric patient for noncardiac surgery. Clin Cardiol. 2020;43: 127−36.
15. Stahlschmidt A, Passos SC, Cardoso GR, et al. Enhanced perioperative care to improve outcomes for high-risk surgical patients in Brazil: a single-centre before-and-after cohort study. Anaesthesia. 2022;77:416−27.
16. Stahlschmidt A, Passos SC, Cardoso GR, et al. Postoperative intensive care allocation and mortality in high-risk surgical patients: evidence from a low- and middle-income country cohort. Braz J Anesthesiol. 2024;74:844517.
17. Partridge JS, Harari D, Martin FC, Dhesi JK. The impact of preoperative comprehensive geriatric assessment on postoperative outcomes in older patients undergoing scheduled surgery: a systematic review. Anaesthesia. 2014;69(Suppl 1):8−16.
18. Partridge JSL, Moonesinghe SR, Lees N, Dhesi JK. Perioperative care for older people. Age Ageing. 2022;51:afac194.
19. Chen L, Zong W, Luo M, Yu H. The impact of comprehensive geriatric assessment on postoperative outcomes in elderly surgery: a systematic review and meta-analysis. PLoS One. 2024;19: e0306308.
20. Miziara ID, Carmen Silvia Molleis Galego M. Patients waiting lists and the COVID-19 pandemic: A moral dilemma. Perioper Care Oper Room Manag. 2021;24:100200.
21. Bastos LBR, Barbosa MA, Rosso CFW, et al. Practices and challenges on coordinating the Brazilian Unified Health System. Rev Saude Publica. 2020;54:25.
22. Paim J, Travassos C, Almeida C, Bahia L, Macinko J. The Brazilian health system: history, advances, and challenges. Lancet. 2011;377:1778−97.