Shabbir M.H. Alibhai, MD, MSc, FRCP(C)
Staff Physician, University Health Network,
Instructor, University of Toronto,
The last few decades have seen major advances in the surgical management of numerous illnesses. As the proportion of the elderly in the general population continues to increase, the prevalence of many chronic conditions also increases. Given the number of available surgical therapeutic options to cure or palliate these chronic conditions, more and more elderly patients are undergoing surgery. Conventional wisdom suggests that, compared to younger or middle-aged patients, older individuals have a higher risk of perioperative and postoperative complications, including death. This increased risk has been attributed to aging itself. This article will examine this relationship in greater detail.
Dozens of studies have suggested that advanced age leads to an increased risk of experiencing surgical complications. This includes an increased risk of postoperative complications such as deep venous thrombosis, infections (including wound, urinary tract, and lung), delirium and mortality.1 In preoperative assessment clinics, internists and anesthetists utilize risk indices or algorithms to determine an individual patient's surgical risk and potentially modifiable risk factors.