The American College of Surgeons National Surgical Quality Improvement Program and the American Geriatrics Society reported a checklist for geriatric patients prior to surgery.
Basic medical evaluation:
(1) complete history and physicial examination
(2) appropriate preoperative diagnostic tests
CNS functional assessment:
(1) cognitive ability
(2) screen for depression
(3) identify risk factors for delirium
(4) screen for substance abuse (alcohol, drugs)
Physical assessment:
(1) cardiac assessment appropriate to the type of surgery
(2) risk factors for postoperative pulmonary complications
(3) nutritional status
(4) risk for falls
(5) functional status and any evidence of frailty
(6) other risk factors for complications (renal, infection, etc) (*)
Pharmacologic assessment:
(1) medication history
(2) evidence of polypharmacy
(3) any medications associated with a discontinuation syndrome (*)
Social assessment:
(1) family support
(2) social support
Assessment relative to operative procedure:
(1) capacity to understand and consent in general
(2) understanding of the procedure (*)
(3) treatment goals
(4) expectations for outcomes
(*) items added to original checklist
