MAJOR SURGERY IN OLD PEOPLE

AS THE older age group of the population increases, the problem of surgery for these patients has become increasingly important. It is generally recognized that operations entail a greater risk in old persons than in younger ones, but there is probably general overestimation of risk and underestimation of what can be done to and for the elderly patient.

Review of the experience of others indicates this greater risk and also that emergency surgery is not tolerated as well as elective operations. Table 1 summarizes some of the recently reported mortality rates in geriatric surgery. It is unwarranted to attempt absolute comparison of mortality statistics for several reasons. Many of the series are too small for accurate statistical comparison. Varied criteria have been used in different reports to differentiate old patients. Mortality varies with surgical indications. Obviously, if many patients are refused surgical treatment because of the grave risk involved, they