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Geriatrics
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Comprehensive Geriatric Assessment of Older Surgical Patients
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Comprehensive Geriatric Assessment of Older Surgical Patients

A special issue of Geriatrics (ISSN 2308-3417).

Deadline for manuscript submissions: 20 April 2027 | Viewed by 1184

Special Issue Editors

Dr. David Shipway

E-Mail Website
Guest Editor
CLARITY (Collaborative Ageing Research) Group, North Bristol NHS Trust, Bristol, UK
Interests: geriatrics
Dr. Frances Rickard

E-Mail Website
Guest Editor
Geriatric Medicine, NHS North Bristol NHS Trust, Bristol, UK
Interests: geriatric perioperative care; major trauma; end of life care

Special Issue Information

Dear Colleagues, 

Advancing age is a risk factor for the development of oncological, vascular and degenerative diseases. The optimal treatment of these pathologies often includes surgery. However older patients are at higher risk of adverse outcomes from surgery, including mortality, complications and functional decline. The reasons for this are complex but linked with the increased prevalence of medical comorbidity in older age, combined with physiological changes in ageing. These factors increase the risk of medical complications in the perioperative period.

However, emerging evidence from a small number of clinical studies indicates that a comprehensive geriatric assessment (CGA) based approach may reduce these risks of surgery and improve outcomes for patients. However, such evidence is limited to a handful of surgical specialties or clinical settings. Further research is needed to establish what the effect of CGA is on surgical patients in specialties which have not yet been adequately studied.

This Special Issue will focus on publishing original research examining the effect of CGA-based care in older patients undergoing surgery, or in those displaying surgical pathology, such as aspects of geriatric trauma. It will also provide a publication opportunity for researchers reporting real-life implementation of CGA-based perioperative care and the outcomes of service development. 

Dr. David Shipway
Dr. Frances Rickard
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Geriatrics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • comprehensive geriatric assessment
  • older adults
  • surgery
  • perioperative medicine
  • trauma

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

14 pages, 551 KB  
Article
Frailty Predicts Neurological Outcome in Chronic Subdural Hematoma: A Single-Center Prospective Cohort Study
by Tobias Philip Schmidt, Christian Jacquemain, Jule Rupprecht, Kerstin Jütten, Laura Schlager, Christian Blume, Michael Veldeman, Hans Clusmann, Anke Höllig and Catharina Conzen-Dilger
Geriatrics 2026, 11(3), 62; https://doi.org/10.3390/geriatrics11030062 (registering DOI) - 19 May 2026
Abstract
Objectives: Frailty, reflecting reduced physiological reserve, has emerged as a predictor of postoperative outcomes in neurosurgery and may provide greater prognostic value than age. In chronic subdural hematoma (cSDH), prospective data remain scarce. This study investigates the association between preoperative frailty, assessed using [...] Read more.
Objectives: Frailty, reflecting reduced physiological reserve, has emerged as a predictor of postoperative outcomes in neurosurgery and may provide greater prognostic value than age. In chronic subdural hematoma (cSDH), prospective data remain scarce. This study investigates the association between preoperative frailty, assessed using the Clinical Frailty Scale (CFS), and postoperative recovery in cSDH patients. Methods: In this ongoing prospective single-center cohort study, 78 consecutive patients (≥60 years) with cSDH were enrolled between August 2022 and October 2024. After exclusion of four conservatively managed patients, 74 surgically treated patients were included in the analysis. Frailty was defined as Clinical Frailty Scale (CFS) ≥ 5. The primary outcome was the Glasgow Outcome Scale-Extended at 6 months (GOSE6). Secondary outcomes included GOSE at discharge (GOSE0) and three months (GOSE3), revision surgery, intensive care unit (ICU) admission, and mortality after six months. Results: Higher CFS scores significantly correlated with poorer outcome at 6 months (r = −0.68, padj = 0.011). In regression analysis, frailty (p < 0.001), age (padj = 0.014), and revision surgery (padj = 0.009) were significant predictors of outcome. Frailty was associated with a reduced likelihood of a good neurological outcome (OR = 0.02, 95% CI: [0.004, 0.085]). Frail patients had significantly poorer outcomes at all timepoints (all padj = 0.014) and none achieved a favorable outcome (GOSE ≥ 6). Six-month mortality was significantly higher in frail patients compared to non-frail patients (32% vs. 4%, padj = 0.048, relative risk RR = 3.29, 95% CI [1.67, 5.78]). Conclusions: Our interim results suggest that preoperative frailty, as measured by the CFS, is strongly associated with poorer neurological recovery and higher mortality following surgical treatment of cSDH. Frailty assessment may facilitate individualized treatment strategies and improve risk stratification beyond age or comorbidity burden. Full article
(This article belongs to the Special Issue Comprehensive Geriatric Assessment of Older Surgical Patients)
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11 pages, 1188 KB  
Article
Patient-Centred Care for Older Patients Considering Surgery: An Evaluation of the Perioperative Care of Older Patients Service at an Australian Tertiary Hospital
by Rachel Aitken, Katherine Gregorevic, Michelle Preeo, Ross Bicknell, Alyssa Griffiths, Jared Tower, Ned Douglas, Chuan-Whei Lee, Janette Wright, Jai Darvall and Wen Kwang Lim
Geriatrics 2026, 11(3), 55; https://doi.org/10.3390/geriatrics11030055 (registering DOI) - 28 Apr 2026
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Abstract
Background/Objectives: As mounting numbers of older people consider surgery, the importance of aligning treatments with patient values and goals is paramount. This has led to the growth of POPS (Perioperative care of Older Patients) services internationally and across Australia. An observational pilot [...] Read more.
Background/Objectives: As mounting numbers of older people consider surgery, the importance of aligning treatments with patient values and goals is paramount. This has led to the growth of POPS (Perioperative care of Older Patients) services internationally and across Australia. An observational pilot evaluation of the Melbourne Health POPS service was conducted throughout 2022, with the aims of describing the population, measuring patient-reported outcomes and comparing postoperative outcomes to a matched historical cohort. Methods: Data were sourced from clinical review, electronic medical records and health intelligence. Patients who pursued surgery were matched 2:1 with a 2020 control cohort on up to 10 characteristics ranked on clinical judgement. Patient-reported outcomes were collected at 3 months post-surgery or at the clinic in consenting participants. Results: There were 128 participants, of whom 64 (50%) pursued non-surgical management. Participants were older (median 79 [13] years), frail (median CFS 5 [2]), and multimorbid (median CCI 5 [2.25]). Despite increased perioperative risk amongst the POPS surgical group (ASA-4 23.4% vs. 5.5%, p < 0.001), increased incidence of postoperative delirium (15% vs. 5.8%, p = 0.042) and ICU admission (21.7% vs. 7.5%, p = 0.006) compared to the control group, median length of stay was similar (4.3 [6.7] vs. 4.3 [5.1] days, p = 0.537). Patient-reported outcomes were similar between surgical and non-surgical POPS groups (90.7% vs. 88.1% would make the same surgical decision, p = 0.697). Conclusions: Patients attending POPS were multimorbid with geriatric syndromes and elevated perioperative risk. A high proportion pursued non-operative care. Patient-reported feedback was high with low decisional regret. Full article
(This article belongs to the Special Issue Comprehensive Geriatric Assessment of Older Surgical Patients)
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