Surgical Emergencies in Patients with Significant Comorbid Diseases.

Chronic critical illness Comorbidities Critical care Frailty Organ failure Surgical emergency

Journal

The Surgical clinics of North America
ISSN: 1558-3171
Titre abrégé: Surg Clin North Am
Pays: United States
ID NLM: 0074243

Informations de publication

Date de publication:
Dec 2023
Historique:
medline: 1 11 2023
pubmed: 15 10 2023
entrez: 14 10 2023
Statut: ppublish

Résumé

Emergency surgery in patients with significant comorbidities benefits from a structured approach to preoperative evaluation, intra-operative intervention, and postoperative management. Providing goal concordant care is ideal using shared decision-making. When operation cannot achieve the patient's goal, non-operative therapy including Comfort Care is appropriate. When surgical therapy is offered, preoperative physiology-improving interventions are far fewer than in other phases. Reevaluation of clinical care progress helps define trajectory and inform goals of care. Palliative Care Medicine may be critical in supporting loved ones during a patient's critical illness. Outcome evaluation defines successful strategies and outline opportunities for improvement.

Identifiants

pubmed: 37838465
pii: S0039-6109(23)00106-8
doi: 10.1016/j.suc.2023.06.003
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1231-1251

Informations de copyright

Published by Elsevier Inc.

Auteurs

Jacqueline Blank (J)

Department of Surgery, Division of Trauma, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, 51 North 39th Street, MOB 1, Suite 120, Philadelphia, PA 19104, USA.

Adam M Shiroff (AM)

Department of Surgery, Division of Trauma, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, 51 North 39th Street, MOB 1, Suite 120, Philadelphia, PA 19104, USA; Surgical Services, Section of Surgical Critical Care and Emergency General Surgery, Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Philadelphia, PA 19104, USA.

Lewis J Kaplan (LJ)

Department of Surgery, Division of Trauma, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, 51 North 39th Street, MOB 1, Suite 120, Philadelphia, PA 19104, USA; Surgical Services, Section of Surgical Critical Care and Emergency General Surgery, Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Philadelphia, PA 19104, USA. Electronic address: Lewis.Kaplan@pennmedicine.upenn.edu.

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Classifications MeSH