Risk stratification and early detection and management of postoperative complications in an aging population
Complications in the elderly after surgery: better prediction is necessary, additional checkups alone are not enough
Due to the aging population, more and more elderly people are undergoing surgery. Although surgery is often necessary to improve quality of life, older patients have an increased risk of complications after the procedure. Annick Stolze's research shows that the current way hospitals assess and monitor these risks is still insufficiently tailored to this growing patient group.
Hospitals use various risk scores and checkups to predict which patients may experience problems after surgery. Stolze focused on how well these existing scores work in elderly people and whether additional, planned checkups by an anesthesiologist after surgery contribute to better outcomes, such as fewer complications, lower mortality, and a better quality of life.
The research results show that while the current risk scores do provide some insight into which elderly patients are at increased risk, they are far from accurate. In other words, they help, but still leave too much uncertainty. Furthermore, Stolze demonstrates that a standard additional visit by an anesthesiologist after surgery, in addition to usual care, does not significantly improve mortality rates, the number of complications, or the perceived quality of life of patients.
This does not mean that aftercare by anesthesiologists is unimportant, but it does mean that additional checkups do not automatically lead to better results. A key finding is that anesthesiologists' advice is not always followed in practice. Moreover, the risk of death in the group studied was lower than expected, making the effect of additional care more difficult to demonstrate.
Healthcare is under pressure due to staff shortages and increasing demand. Stolze's research underscores that adding standard additional care for all elderly patients is not effective. Instead, a more targeted approach is needed, specifically identifying the most vulnerable elderly and providing them with additional support.
According to Stolze, the future lies in better personalized care. This can be achieved, for example, through improved risk models and the use of smart technology, such as continuous monitoring, to detect deterioration more quickly. This research makes it clear to patients, healthcare providers, and policymakers that investing in targeted and smart aftercare is essential to improve the quality of care for the elderly and to keep care affordable and feasible.
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