Checklist for the optimal preoperative assessment of the geriatric surgical patient

In addition to conducting a complete history and physical examination of the patient, the following assessments are strongly recommended:

Assess the patient's cognitive ability and capacity to understand the anticipated surgery.

Screen the patient for depression.

Identify the patient's risk factors for developing postoperative delirium.

Screen for alcohol and other substance abuse/dependence.

Perform a preoperative cardiac evaluation according to the American College of Cardiology/American Heart Association algorithm for patients undergoing noncardiac surgery.

Identify the patient's risk factors for postoperative pulmonary complications and implement appropriate strategies for prevention.

Document functional status and history of falls.

Determine baseline frailty score.

Assess patient's nutritional status and consider preoperative interventions if the patient is at severe nutritional risk.

Take an accurate and detailed medication history and consider appropriate perioperative adjustments. Monitor for polypharmacy.

Determine the patient's treatment goals and expectations in the context of the possible treatment outcomes.

Determine patient's family and social support system.

Order appropriate preoperative diagnostic tests focused on older patients.

Determine venue for surgery.

Original figure modified for this publication. From: Chow WB, Rosenthal RA, Merkow RP, et al. Optimal preoperative assessment of the geriatric surgical patient: a best practices guideline from the American College of Surgeons National Surgical Quality Improvement Program and the American Geriatrics Society. J Am Coll Surg 2012; 215:453. Table used with the permission of Elsevier, Inc. All rights reserved.

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Checklist for the optimal preoperative assessment of the geriatric surgical patient