• David B Loran, Brannon R Hyde, and Joseph B Zwischenberger.
• Department of Surgery, The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA.
• Surg. Clin. North Am. 2005 Dec 1;85(6):1259-66, xi.

AbstractAmericans over age 65 represent the fastest growing segment of the United States population. As a result, the demographic landscape of America is changing. Knowledge of aged physiology is necessary to construct a risk-benefit analysis tailored for each patient to improve perioperative outcomes and lower the morbidity and mortality rates among the elderly. Benefit estimates should account for a patient's life expectancy and quality of life before and after surgery. With aging, baseline functions of almost every organ system undergo progressive decline resulting in a decreased physiologic reserve and ability to compensate for stress. Pain control, postoperative cognitive dysfunction, end-of-life issues, and realistic expectations after surgery are paramount issues throughout the perioperative period.

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