Issues

Risk of infections and postoperative surgical site infections in geriatric patients

Journal: Osteologie
ISSN: 1019-1291
Topic:

Alterstraumatologie

Issue: Issues of 2014 (Vol. 23): Issue 1 2014 (1-72)
Pages: 11-15

Risk of infections and postoperative surgical site infections in geriatric patients

H. J. Heppner (1, 2), K. Singler (3, 4), U. Thiem (5), J. Franzen (6)

(1) HELIOS Klinikum Schwelm GmbH, Klinik für Geriatrie und geriatrische Tagesklinik, Schwelm; (2) Lehrstuhl für Geriatrie der Universität Witten/Herdecke, Witten; (3) Institut für Biomedizin des Alterns der Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg; (4) Klinik für Geriatrie, Zentrum für Altersmedizin, Klinikum Nürnberg, Nürnberg; (5) Klinik für Geriatrie und geriatrische Frührehabilitation, Marienhospital Herne, Universität Bochum, Herne; (6) HELIOS Klinikum Schwelm GmbH, Klinik für Unfallchirurgie und orthopädische Chirurgie, Schwelm

Keywords

Geriatrics, Surgical site infections, prevention of infection

Summary

Due to demographic shifts, the number of elderly patients treated for postoperative infections is increasing. Therefore in the future treatment of geriatric patients and knowledge of physiological changes in the elderly must be centered. In older adults infections are one of the most common causes of mortality. In these patients course of infections is more severe and often lethal and surgical site infections occur in about 17 % of all hospital-acquired infections. During the physiologic ageing process, various organ systems are affected that are important for response to infection. Structural and functional changes take place in the organ systems, which modify patients’ immune and defense status and physiologic stress response. Also the number of chronic conditions increases with increasing age; on average, 3 to 9 concomitant conditions (diabetes mellitus, arterial hypertension, osteoporosis, incontinence, chronic bronchitis, heart failure, impairment of cognitive performance, etc.) are to be expected, which inevitably increases the risk of complications and, partially as a result, morbidity and mortality from most infectious diseases increase with ascending age. The most prominent comorbidities triggering infections are diabetes mellitus and chronic heart failure. There are various options to minimize the risk of peri- and postoperative infections such as keeping normothermia, tight monitoring of bloodglucose levels, the use of heat treatment and early mobilisation of critically ill patients. This also includes an early acute geriatric rehabilitation. To ensure success of treatment the interdiciplinary and interprofessional dialogue is essential.

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