Elderly patient and surgery. A case of professional liability?

Francesco La Sala¹, Bartolo Caggiano²

¹Department of Prevention, ASL Avellino, Avellino, Italy - ²Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy

Introduction: In advanced healthcare systems, increasing attention is being placed on controlling potential medical assistance-related risks. In Western countries it is estimated that the over-65 population will grow steadily in the coming decades and consequently a greater number of the patients undergoing surgery and medical treatments will be elderly and therefore at greater risk.

Case presentation: An 80-year-old man underwent a right knee replacement due to severe osteoarthritis. After surgery, he manifested post-operative delirium. He received benzodiazepine treatment with poor results and subsequently did not regain adequate cognitive functions, dying two years later in a nursing home. The case had legal implications concerning medical professional liability in post-operative management.

Discussion: Risk management in elderly patient therapy is a growing challenge for Western Healthcare Systems. The percentage of elderly patients undergoing orthopedic surgery who experience delirium varies from 28-41%. Elderly patients with delirium are more prone to functional decline, institutionalization, and death. Treatment plans must consider advanced age represents a significant risk factor to maximize patient safety.