Perioperative Risk Assessment in the Surgical Care of Geriatric Patients

The geriatric population comprises an increasing percentage of the overall population in the United States. Currently 13.6% of the population is age 65 or older, and 6% are 80 or older [1]. The importance of oral health within the geriatric sector has been given more recognition, because there is a synergistic relationship between oral health and overall health. Advances in surgical and anesthetic techniques combined with sophisticated perioperative monitoring are factors that have contributed to an expanding number of older adults undergoing oral surgery. The elderly often have multiple comorbid conditions limiting their functional capacity to withstand the stress of surgery and postoperative recovery. As such, surgical management becomes more challenging and the role of oral and maxillofacial surgeons becomes paramount. It involves clinical competency and ability to evaluate carefully the pathophysiologic risk of comorbid disease in order to provide safe, expedient, and effective surgical care. This review paper attempts to focus on the importance of perioperative risk assessment when applying oral surgical therapeutics to geriatric patients. Specifically, medical workup of comorbid systemic illnesses and pharmacologic therapy are assessed in order to determine appropriate treatment strategies for successful surgical outcomes.