YAŞLI HASTANIN AMELİYAT SONRASI BAKIMINDAKİ FARKLILIKLAR

Esra Usta; Dilek Aygin

-

Yıl 2015, Cilt: 5 Sayı: 3, 59 - 65, 25.10.2015

Öz

Elderly population is rising rapidly in our country as well as all over the world. It is estimated that half of the elderly ingeneral population have experienced surgical operation for purposes of improving the health, reducing the inadequatefunction, relief of pain and suffering, protecting the quality of life. Physiological changes are brought by aging anddepending on conditions such as chronic diseases, elderly little tolerate surgery, surgical morbidity and mortality ratesare higher than youngsters. However, minimizing postoperative complications, improving the survival rate, keeping thequality of life in optimum level is possible with an efficient, adequate, planned and qualified care for elderly patientwho experienced surgical operation. In this article; anatomic and physiological changes which related to aging and careattempts for prospective postoperative problems are discussed

Anahtar Kelimeler

Elderly; elderly care; surgery; complication; postoperative

Kaynakça

Kutsal GY. Yaşlanan dünya. Türk Fiz Tıp Rehab Derg. 2006; 52 (Özel Ek A): A6-11.
TÜİK [İnternet]. Nüfus projeksiyonları, 2013-2075. 2013. [Erişim Tarihi: 15 Mart 2013]. Erişim Adresi: http:// www.tuik.gov.tr/HbPrint. do?id= 15844.
Wallace J. Geriatrik Cerrahi. Mcintyre RC, Stiegmann GV, Eiseman B, editors. Özmen MM, Baskan S, çev. Ed. Cerrahide Karar Verme. Ankara: Güneş Tıp Kitabevi; 2007. s. 38-40.
Whoindia.org [Internet]. Guidelines for common surgical interventions in the elderly. principles of geriatric surgery. 2008. [Cited: 2013 May 02].Available from: http://www.whoindia.org/
Wilkinson K, Martin IC, Gough MJ, Stewart JAD, Lucas SB, Freeth H et al. An age old problem a review of the care received by elderly patients undergoing surgery [Internet]. 2010. [Cited: 2013 Jun 02]. Available from: http://www.ncepod.org.uk/2010report3/downloads/EES E_fullReport.pdf
Kaye KS, Anderson DJ, Sloane R, Chen LF, Choi Y, Link K et al. The impact of surgical site infection on older operative patients. Am Geriatr Soc. 2009; 57(1): 46-54.
Mayir B, Altınel Ö, Özerhan İH, Ersöz N, Harlak A, Kılbaşı Z ve ark. Yaşlı hastalarda cerrahi sonrası mortaliteye etki eden faktörler. Anatol J Clin Investig. 2010; 4(1): 32-5.
Oruç MT, Uzun S, Saylam B, Karakahya M, Karadağ Ç, Düzgün AP ve ark. İleri yaşta acil ve elektif şartlarda cerrahi tedavi. Türk Geriatri Dergisi. 2004; 7(1): 37-40.
Ağalar F, Özdoğan M, Daphan ÇE, Topaloğlu S, Sayek İ. Akut karınla başvuran geriatrik hastalarda cerrahi tedavi ve sonuçları. Geriatri. 1999; 2(1): 1-4.
Aygin D, Aslan FE, Cengiz H. Yaşlı cerrahi hastasında ameliyat sonrası erken dönem. Akademik Geriatri Dergisi. 2011; 4(2): 12-7.
Erdil F. Yaşlılarda ameliyat sonrası bakım. Hacettepe Üniversitesi Gebam Bülteni [İnternet]. 2008. [Erişim tarihi: http://www.gebam.hacettepe.edu.tr/. 2014]. Erişim Adresi:
Lagoo-Deenadayalan SA, Newell MA and Pofahl WE. Common perioperative complications in older patients. In: Rosenthal RA, Zenilman ME and Katlic MR, editors. Principles and practice of geriatric surgery. 2nd ed. New York: Springer; 2011. p. 361-76.
Auerback AD and Goldman L. Beta-blockers and reduction of cardiac events in noncardiac surgery. JAMA. 2002; 287(11): 1435-44.
Polanczyk CA, Marcantonio E, Goldman L, Rohde LEP, Orav J, Mangione CM et al. Impact of age on perioperative complications and length of stay in patients undergoing noncardiac surgery. Ann Intern Med. 2001; 134(8): 637-43.
Jin F and Chung F. Minimizing perioperative adverse events in the elderly. Br J Anaesth. 2001; 87(4): 608- 24.
American Heart Association-AHA. 2009 ACCF/aha focused update on perioperative beta blockade ıncorporated ınto the ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery. J Am Coll Cardiol. 2009; 54(22): e13-118.
Sullivan J. Caring for older adults after surgery. Nursing. 2011; 41(4): 48-51.
Cheng SP, Yang TL, Jeng KS, Lee JJ, Liu TP and Liu CL. Perioperative care of the elderly. International Journal of Gerontology. 2007; 1(2): 89-97.
Ersan T. Perioperative management of the geriatric patient. Medscape [Internet] 2013. [Updated: 2013 Jul 25; Cited: http://emedicine.medscape.com/article/285433- overview.
30]. Available from:
Sieber FE and Barnett SR. Preventing postoperative complications in the elderly. Anesthesiology Clin. 2011; 29(1): 83-97.
BergH , Roed J, Viby-Mogensen J, Mortensen CR, Engbaek J, Skovgaard LT et al. Residual neuromuscular block is a risk factor for postoperative pulmonary complications. A prospective, randomised, and blinded study of postoperative pulmonary complications after atracurium, vecuronium and pancuronium. Acta Anaesthesiol Scand. 1997; 41(9): 1095-103.
Lawrence VA, Cornell JE and Smetana GW. Strategies to reduce postoperative pulmonary complications after noncardio thoracic surgery: systematic review for the American College of Physicians. Ann Intern Med. 2006; 144(8): 596-608.
Schneider GT, Christensen N and Doerr TD. Early tracheotomy in elderly patients results in less ventilator- associated pneumonia. Otolaryngol Head Neck Surg. 2009; 140(2): 250-5.
SprungJ, Gajic O and Warner DO. Review article: age related alterations in respiratory function - anesthetic considerations. Can J Anaesth. 2006; 53(12): 1244-57.
Jaffer AK and Brotman DJ. Prevention of venous thromboembolism in the geriatric patient. Clin Geriatr Med. 2006; 22(1): 93-111.
Amador LF and Goodwin JS. Postoperative delirium in the older patient. J Am Coll Surg. 2005; 200(5): 767- 73.
Robinson TN, Raeburn CD, Tran ZV, Angles EM, Brenner LA and Moss M. Postoperative delirium in the elderly: risk factors and outcomes. Ann Surg. 2009; 249(1): 173-8.
Inouye SK. Delirium in older persons. N Engl J Med. 2006; 354(11): 1157-65.
Stockl KM, Le L, Zhang S and Harada AS. Clinical and economic outcomes associated with potentially inappropriate prescribing in the elderly. Am J Manag Care. 2010; 16(1): e1-10.
Dasgupta M and Dumbrell AC. Preoperative risk assessment for delirium after noncardiac surgery: a systematic review. J Am Geriatr Soc. 2006; 54(10): 1578-89.
Kalisvaart KJ, de Jonghe JF, Bogaards MJ, Vreeswijk R, Egberts TC, Burger BJ et al. Haloperidol prophylaxis for elderly hip-surgery patients at risk for delirium: a randomized placebo-controlled study. J Am Geriatr Soc. 2005; 53(10): 1658-66.
Huang J. Delirium. The Merck Manual Professional Edition [Internet]. 2013 April. [Cited: 2013 Jun 05]. Available from:http://www.merckmanuals.com/professional/neur ologic_disorders/delirium_and_dementia/delirium.html #v1036383
YoungJ, Murthy L, Westby M, Akunne A and O'Mahony R. Diagnosis, prevention, and management of delirium: summary of NICE guidance. BMJ. 2010; 341: c3704. doi: 10.1136/bmj.c3704.
Horgas AL, Yoon SL and Grall M. Nursing standard of practice protocol: pain management in older adults. Hartford Institute for Geriatric Nursing. [Internet]. 2012 July. [Cited: 2013 Jun 01]. Available from: http://consultgerirn.org/topics/pain/want_to_know_mor e
Horgas AL. Try this: best practices in nursing care to older adults with dementia. Assessing pain in older adults with dementia. The Hartford Institute for Geriatric Nursing. [Internet]. 2012. [Cited: 06 Jun 2013]. from:http://consultgerirn.org/uploads/File/trythis/try_th is_d2.pdf. Available
American Geriatrics Society. American Geriatrics Society Panel on pharmacological management of persistent pain in older persons. J Am Geriatr Soc. 2009; 57(8): 1331-46.
Kroshinsky D and Strazzula L. Pressure ulcers. The Merck Manual Professional Edition [Internet]. 2013 March. from:http://www.merckmanuals.com/professional/derm atologic_disorders/pressure_ulcers/pressure_ulcers.htm l#v967388. Jun 06]. Available
Uzun Ö. Yaşlı hastanın perioperatif hemşirelik bakımı. Ege Üniversitesi Hemşirelik Yüksekokulu Dergisi. 2000; 16(1): 107-17.
Barie PS and Eachempati SR. Surgical site infections. Surg Clin North Am. 2005; 85(6): 1115-35.
Dellinger EP, Hausmann SM, Bratzler DW, Johnson RM, Daniel DM, Bunt KM et al. Hospitals collaborate to decrease surgical site infections. Am J Surg. 2005; 190(1): 9-15.

YAŞLI HASTANIN AMELİYAT SONRASI BAKIMINDAKİ FARKLILIKLAR

Yıl 2015, Cilt: 5 Sayı: 3, 59 - 65, 25.10.2015

Esra Usta Dilek Aygin

Öz

ÖZET

Yaşlı nüfus tüm dünyada olduğu gibi ülkemizde de hızla artış göstermektedir. Genel popülasyondaki yaşlıların yarısının, sağlığının yükseltilmesi, fonksiyon yetersizliğinin azaltılması, ağrının ve ızdırabın dindirilmesi ve yaşam kalitesinin korunması amacıyla cerrahi girişim deneyimlediği tahmin edilmektedir. Yaşlanmanın getirdiği fizyolojik değişiklikler, kronik hastalıklar gibi durumlara bağlı olarak yaşlılar cerrahi girişimi daha az tolere etmekte, cerrahi morbidite ve mortalite oranları gençlere göre daha yüksek olmaktadır. Ancak cerrahi girişim geçiren yaşlı hastaya verilecek olan etkili, yeterli, planlı ve kaliteli bir bakım ile ameliyat sonrası komplikasyonların en aza indirgenmesi, sağkalım oranının arttırılması ve yaşam kalitesinin optimum düzeyde tutulması mümkündür.

Bu makalede; yaşlanmaya bağlı meydana gelen anatomik-fizyolojik değişiklikler ve ameliyat sonrası karşılaşılabilecek sorunlara yönelik bakım girişimleri tartışılmıştır.

Anahtar Kelimeler

yaşlı; yaşlı bakımı; cerrahi; komplikasyon; ameliyat sonrası

Kaynakça

Kutsal GY. Yaşlanan dünya. Türk Fiz Tıp Rehab Derg. 2006; 52 (Özel Ek A): A6-11.
TÜİK [İnternet]. Nüfus projeksiyonları, 2013-2075. 2013. [Erişim Tarihi: 15 Mart 2013]. Erişim Adresi: http:// www.tuik.gov.tr/HbPrint. do?id= 15844.
Wallace J. Geriatrik Cerrahi. Mcintyre RC, Stiegmann GV, Eiseman B, editors. Özmen MM, Baskan S, çev. Ed. Cerrahide Karar Verme. Ankara: Güneş Tıp Kitabevi; 2007. s. 38-40.
Whoindia.org [Internet]. Guidelines for common surgical interventions in the elderly. principles of geriatric surgery. 2008. [Cited: 2013 May 02].Available from: http://www.whoindia.org/
Wilkinson K, Martin IC, Gough MJ, Stewart JAD, Lucas SB, Freeth H et al. An age old problem a review of the care received by elderly patients undergoing surgery [Internet]. 2010. [Cited: 2013 Jun 02]. Available from: http://www.ncepod.org.uk/2010report3/downloads/EES E_fullReport.pdf
Kaye KS, Anderson DJ, Sloane R, Chen LF, Choi Y, Link K et al. The impact of surgical site infection on older operative patients. Am Geriatr Soc. 2009; 57(1): 46-54.
Mayir B, Altınel Ö, Özerhan İH, Ersöz N, Harlak A, Kılbaşı Z ve ark. Yaşlı hastalarda cerrahi sonrası mortaliteye etki eden faktörler. Anatol J Clin Investig. 2010; 4(1): 32-5.
Oruç MT, Uzun S, Saylam B, Karakahya M, Karadağ Ç, Düzgün AP ve ark. İleri yaşta acil ve elektif şartlarda cerrahi tedavi. Türk Geriatri Dergisi. 2004; 7(1): 37-40.
Ağalar F, Özdoğan M, Daphan ÇE, Topaloğlu S, Sayek İ. Akut karınla başvuran geriatrik hastalarda cerrahi tedavi ve sonuçları. Geriatri. 1999; 2(1): 1-4.
Aygin D, Aslan FE, Cengiz H. Yaşlı cerrahi hastasında ameliyat sonrası erken dönem. Akademik Geriatri Dergisi. 2011; 4(2): 12-7.
Erdil F. Yaşlılarda ameliyat sonrası bakım. Hacettepe Üniversitesi Gebam Bülteni [İnternet]. 2008. [Erişim tarihi: http://www.gebam.hacettepe.edu.tr/. 2014]. Erişim Adresi:
Lagoo-Deenadayalan SA, Newell MA and Pofahl WE. Common perioperative complications in older patients. In: Rosenthal RA, Zenilman ME and Katlic MR, editors. Principles and practice of geriatric surgery. 2nd ed. New York: Springer; 2011. p. 361-76.
Auerback AD and Goldman L. Beta-blockers and reduction of cardiac events in noncardiac surgery. JAMA. 2002; 287(11): 1435-44.
Polanczyk CA, Marcantonio E, Goldman L, Rohde LEP, Orav J, Mangione CM et al. Impact of age on perioperative complications and length of stay in patients undergoing noncardiac surgery. Ann Intern Med. 2001; 134(8): 637-43.
Jin F and Chung F. Minimizing perioperative adverse events in the elderly. Br J Anaesth. 2001; 87(4): 608- 24.
American Heart Association-AHA. 2009 ACCF/aha focused update on perioperative beta blockade ıncorporated ınto the ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery. J Am Coll Cardiol. 2009; 54(22): e13-118.
Sullivan J. Caring for older adults after surgery. Nursing. 2011; 41(4): 48-51.
Cheng SP, Yang TL, Jeng KS, Lee JJ, Liu TP and Liu CL. Perioperative care of the elderly. International Journal of Gerontology. 2007; 1(2): 89-97.
Ersan T. Perioperative management of the geriatric patient. Medscape [Internet] 2013. [Updated: 2013 Jul 25; Cited: http://emedicine.medscape.com/article/285433- overview.
30]. Available from:
Sieber FE and Barnett SR. Preventing postoperative complications in the elderly. Anesthesiology Clin. 2011; 29(1): 83-97.
BergH , Roed J, Viby-Mogensen J, Mortensen CR, Engbaek J, Skovgaard LT et al. Residual neuromuscular block is a risk factor for postoperative pulmonary complications. A prospective, randomised, and blinded study of postoperative pulmonary complications after atracurium, vecuronium and pancuronium. Acta Anaesthesiol Scand. 1997; 41(9): 1095-103.
Lawrence VA, Cornell JE and Smetana GW. Strategies to reduce postoperative pulmonary complications after noncardio thoracic surgery: systematic review for the American College of Physicians. Ann Intern Med. 2006; 144(8): 596-608.
Schneider GT, Christensen N and Doerr TD. Early tracheotomy in elderly patients results in less ventilator- associated pneumonia. Otolaryngol Head Neck Surg. 2009; 140(2): 250-5.
SprungJ, Gajic O and Warner DO. Review article: age related alterations in respiratory function - anesthetic considerations. Can J Anaesth. 2006; 53(12): 1244-57.
Jaffer AK and Brotman DJ. Prevention of venous thromboembolism in the geriatric patient. Clin Geriatr Med. 2006; 22(1): 93-111.
Amador LF and Goodwin JS. Postoperative delirium in the older patient. J Am Coll Surg. 2005; 200(5): 767- 73.
Robinson TN, Raeburn CD, Tran ZV, Angles EM, Brenner LA and Moss M. Postoperative delirium in the elderly: risk factors and outcomes. Ann Surg. 2009; 249(1): 173-8.
Inouye SK. Delirium in older persons. N Engl J Med. 2006; 354(11): 1157-65.
Stockl KM, Le L, Zhang S and Harada AS. Clinical and economic outcomes associated with potentially inappropriate prescribing in the elderly. Am J Manag Care. 2010; 16(1): e1-10.
Dasgupta M and Dumbrell AC. Preoperative risk assessment for delirium after noncardiac surgery: a systematic review. J Am Geriatr Soc. 2006; 54(10): 1578-89.
Kalisvaart KJ, de Jonghe JF, Bogaards MJ, Vreeswijk R, Egberts TC, Burger BJ et al. Haloperidol prophylaxis for elderly hip-surgery patients at risk for delirium: a randomized placebo-controlled study. J Am Geriatr Soc. 2005; 53(10): 1658-66.
Huang J. Delirium. The Merck Manual Professional Edition [Internet]. 2013 April. [Cited: 2013 Jun 05]. Available from:http://www.merckmanuals.com/professional/neur ologic_disorders/delirium_and_dementia/delirium.html #v1036383
YoungJ, Murthy L, Westby M, Akunne A and O'Mahony R. Diagnosis, prevention, and management of delirium: summary of NICE guidance. BMJ. 2010; 341: c3704. doi: 10.1136/bmj.c3704.
Horgas AL, Yoon SL and Grall M. Nursing standard of practice protocol: pain management in older adults. Hartford Institute for Geriatric Nursing. [Internet]. 2012 July. [Cited: 2013 Jun 01]. Available from: http://consultgerirn.org/topics/pain/want_to_know_mor e
Horgas AL. Try this: best practices in nursing care to older adults with dementia. Assessing pain in older adults with dementia. The Hartford Institute for Geriatric Nursing. [Internet]. 2012. [Cited: 06 Jun 2013]. from:http://consultgerirn.org/uploads/File/trythis/try_th is_d2.pdf. Available
American Geriatrics Society. American Geriatrics Society Panel on pharmacological management of persistent pain in older persons. J Am Geriatr Soc. 2009; 57(8): 1331-46.
Kroshinsky D and Strazzula L. Pressure ulcers. The Merck Manual Professional Edition [Internet]. 2013 March. from:http://www.merckmanuals.com/professional/derm atologic_disorders/pressure_ulcers/pressure_ulcers.htm l#v967388. Jun 06]. Available
Uzun Ö. Yaşlı hastanın perioperatif hemşirelik bakımı. Ege Üniversitesi Hemşirelik Yüksekokulu Dergisi. 2000; 16(1): 107-17.
Barie PS and Eachempati SR. Surgical site infections. Surg Clin North Am. 2005; 85(6): 1115-35.
Dellinger EP, Hausmann SM, Bratzler DW, Johnson RM, Daniel DM, Bunt KM et al. Hospitals collaborate to decrease surgical site infections. Am J Surg. 2005; 190(1): 9-15.

Toplam 41 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	Türkçe
Bölüm	Derlemeler
Yazarlar	Esra Usta Dilek Aygin
Yayımlanma Tarihi	25 Ekim 2015
Gönderilme Tarihi	17 Kasım 2014
Yayımlandığı Sayı	Yıl 2015 Cilt: 5 Sayı: 3

Kaynak Göster

APA	Usta, E., & Aygin, D. (2015). YAŞLI HASTANIN AMELİYAT SONRASI BAKIMINDAKİ FARKLILIKLAR. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 5(3), 59-65.
AMA	Usta E, Aygin D. YAŞLI HASTANIN AMELİYAT SONRASI BAKIMINDAKİ FARKLILIKLAR. DÜ Sağlık Bil Enst Derg. Ekim 2015;5(3):59-65.
Chicago	Usta, Esra, ve Dilek Aygin. “YAŞLI HASTANIN AMELİYAT SONRASI BAKIMINDAKİ FARKLILIKLAR”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 5, sy. 3 (Ekim 2015): 59-65.
EndNote	Usta E, Aygin D (01 Ekim 2015) YAŞLI HASTANIN AMELİYAT SONRASI BAKIMINDAKİ FARKLILIKLAR. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 5 3 59–65.
IEEE	E. Usta ve D. Aygin, “YAŞLI HASTANIN AMELİYAT SONRASI BAKIMINDAKİ FARKLILIKLAR”, DÜ Sağlık Bil Enst Derg, c. 5, sy. 3, ss. 59–65, 2015.
ISNAD	Usta, Esra - Aygin, Dilek. “YAŞLI HASTANIN AMELİYAT SONRASI BAKIMINDAKİ FARKLILIKLAR”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 5/3 (Ekim 2015), 59-65.
JAMA	Usta E, Aygin D. YAŞLI HASTANIN AMELİYAT SONRASI BAKIMINDAKİ FARKLILIKLAR. DÜ Sağlık Bil Enst Derg. 2015;5:59–65.
MLA	Usta, Esra ve Dilek Aygin. “YAŞLI HASTANIN AMELİYAT SONRASI BAKIMINDAKİ FARKLILIKLAR”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, c. 5, sy. 3, 2015, ss. 59-65.
Vancouver	Usta E, Aygin D. YAŞLI HASTANIN AMELİYAT SONRASI BAKIMINDAKİ FARKLILIKLAR. DÜ Sağlık Bil Enst Derg. 2015;5(3):59-65.

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