Surgery in the aged: pre-operative and post-operative care.

Demographic Trends NEARLY half the patients admitted to general wards of hospitals today are over the age of 60 (Lancet, I963); the average age of patients admitted to Geriatric Units varies between 75 and 80, and in the Sunderland Geriatric Unit over onethird of all the admissions are over 80 years. The number of operations performed on patients of 60 and over (excluding orthopaedic and urological conditions) by one surgical team in Sunderland has increased from 344 in 1952 to 614 in I962, those over 60 accounting for 20% of the total number of cases operated on by the team during 1962. Although this figure is loaded by the special co-operation which exists between this surgical team and the geriatric unit, the number of operations performed on patients in the older age groups by other surgical teams in the area has also increased. The following table shows a comparison of the number of operations done in different groups in I952, 1957 and I962, by one surgical team. Co-operation with the Geriatric Unit was unchanged throughout this period. By I975 it is estimated that one-seventh of the total population of England and Wales will be over the age of 60. Already there are 3j million persons in Britain of 70 years and over, and nearly 2,000,000 of 75 years or more (Godber, I962). Clearly in the future Geriatric Units will feel an increasing shortage of beds to the extent that failure to deal with surgical cases may contribute to a complete breakdown.