{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T16:05:22Z","timestamp":1683216322708},"reference-count":68,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Der demografische Wandel f\u00fchrt zu einer zunehmenden Anzahl alter Patienten sowohl in unserer Gesellschaft als auch im Krankenhaus. Mit zunehmendem Alter steigt nicht nur die Anzahl der Vorerkrankungen, sondern auch die postoperative Komplikationsrate und Mortalit\u00e4t. Letztlich ist aber nicht das Alter ausschlaggebend, sondern der Zustand des Patienten und seine Kapazit\u00e4t, sich den k\u00f6rperlichen und mentalen Herausforderungen eines operativen Eingriffs zu stellen. Besonders von Komplikationen bedroht sind gebrechliche Patienten und eine wesentliche \u2013 als Pr\u00e4habilitation \u2013 bezeichnete Strategie besteht darin, diese durch k\u00f6rperliches und mentales Training sowie Ern\u00e4hrungsberatung bereits pr\u00e4operativ in einen besseren Zustand zu versetzen. Das Delir geh\u00f6rt zu den h\u00e4ufigsten postoperativen Komplikationen. Ma\u00dfnahmen, wie der Verzicht auf eine Pr\u00e4medikation mit Benzodiazepinen, die Messung der Narkosetiefe, der Verzicht auf langwirksame Opioide, die Durchf\u00fchrung von Fast-Track\n\t\t\t\t\tSurgery sowie die z\u00fcgige postoperative Bereitstellung von Brille\/H\u00f6rger\u00e4t k\u00f6nnen das Delirrisiko reduzieren. Eine enge interdisziplin\u00e4re Absprache zwischen Chirurgen, An\u00e4sthesisten, Geriatern und Physiotherapeuten ist wesentlich, um das perioperative Vorgehen miteinander abzustimmen und das perioperative Risiko f\u00fcr alte Patienten zu reduzieren.<\/jats:p>","DOI":"10.1055\/a-1447-1051","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T22:30:38Z","timestamp":1624314638000},"page":"296-305","source":"Crossref","is-referenced-by-count":1,"title":["Perioperative Medizin in der Viszeralchirurgie beim alten Patienten aus an\u00e4sthesiologischer Perspektive"],"prefix":"10.1055","volume":"146","author":[{"given":"Martin","family":"S\u00f6hle","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr An\u00e4sthesiologie und Operative Intensivmedizin, Universit\u00e4tsklinikum Bonn, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Coburn","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr An\u00e4sthesiologie und Operative Intensivmedizin, Universit\u00e4tsklinikum Bonn, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,6,21]]},"reference":[{"key":"ref3","volume-title":"Wie gesund sind die \u00e4lteren Menschen?","year":"2015"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1097\/SLA.0000000000001691","article-title":"Inflammatory and Immune Responses to Surgery and Their Clinical Impact","volume":"264","author":"W Alazawi","year":"2016","journal-title":"Ann Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1093\/bja\/85.1.109","article-title":"The stress response to trauma and surgery","volume":"85","author":"J P Desborough","year":"2000","journal-title":"Br J Anaesth"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1093\/bja\/aex002","article-title":"Postoperative pulmonary complications","volume":"118","author":"A Miskovic","year":"2017","journal-title":"Br J Anaesth"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1093\/bja\/aew316","article-title":"Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries","volume":"117","author":"International Surgical Outcomes Study group","year":"2016","journal-title":"Br J Anaesth"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1016\/S0140-6736(12)61148-9","article-title":"Mortality after surgery in Europe: a 7 day cohort study","volume":"380","author":"R M Pearse","year":"2012","journal-title":"Lancet"},{"key":"ref10","first-page":"739","article-title":"Sterblichkeit und Komplikationen nach viszeralchirurgischen Operationen. 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