Adherence to recommended practices for perioperative anesthesia care for older adults among US anesthesiologists: results from the ASA Committee on Geriatric Anesthesia-Perioperative Brain Health Initiative ASA member survey.
Level 4 - case-series / case-control
Cross-sectional survey assessing self-reported clinical practice
PubMed 32123562 · doi:10.1186/s13741-020-0136-9
What was done
A web-based survey was distributed to 25,587 American Society of Anesthesiologists (ASA) members between May 24 and June 29, 2018. The questionnaire assessed the proportion of clinical practice dedicated to older adults, self-reported adherence to recommended geriatric perioperative care practices, resource needs, and practice characteristics.
What was found
A total of 1,737 members answered at least one question (6.8% response rate), with 96.4% reporting caring for a patient aged 65 or older within the prior year. Routine adherence (defined as at least 90% of the time) was reported by 47.1% (95% CI, 44.6% to 49.7%) for multimodal analgesia and 25.5% (95% CI, 23.3% to 27.7%) for preoperative discussions regarding postoperative cognitive changes. Over 80% of respondents reported that preoperative frailty screening, dementia screening, postoperative delirium screening, and preoperative geriatric consultations occurred in fewer than 10% of cases.
Why it matters
This paper identifies a substantial gap between published geriatric anesthesia recommendations and everyday clinical practice among US anesthesiologists, especially in frailty and cognitive screening.
Limits
The survey had an extremely low response rate (6.8%), creating high risk for non-response and selection bias. Data rely entirely on self-reported estimates rather than objective audits of clinical care, and findings are limited to ASA members.
Cited by
- supports A survey of 1,700 anesthesiologists found that only 1 in 10 reported seeing preoperative cognitive assessment tests on high-risk patients aged 65 and older.