RT Journal
A1 Zenilman M
T1 Geriatric surgery: Past, present, and future
JF Archives of Surgery
JO Archives of Surgery
YR 2012
FD January 1
VO 147
IS 1
SP 10
OP 10
DO 10.1001/archsurg.2011.1040
UL http://dx.doi.org/10.1001/archsurg.2011.1040
AB 
Well, that was the past. My position was based on the observation that for most surgical interventions, such as abdominal, cardiac, or vascular surgery, the increase in mortality with age was not based on the actual chronologic number. When concomitant medical diseases were controlled (eg, cardiac, pulmonary and respiratory systems, and emergency situations), the age-related mortality rates increased only slightly. For example, middle-aged persons with 3 comorbidities have similar mortality rates as septuagenarians with the same number of comorbidities. In only a few surgical illnesses such as trauma and burns were mortality rates dependent on chronologic age and independent of comorbidities. The postulate was that if we controlled for these factors, surgery in elderly patients is safe. The Charlson Comorbidity Index is the standard measurement for the concomitant disease.