Preoperative optimization of the high-risk surgical patient

Abstract

After major surgery there is a significant risk of major complications and even death, particularly in the elderly and patients with significant cardiorespiratory disease. In the UK, recent large audits have shown a 30‐day mortality rate of 5.6% for elective colorectal cancer surgery,62 19.3% for emergency colorectal surgery,62 7.3% for elective infrarenal aortic aneurysm and aorto‐iliac occlusive disease surgery,4 9–15% for oesophagectomy and 13–15% for elective gastrectomy.34