[Preoperative conditioning in ageing patients-gerontosurgery]

Adapting the daily hospital routine to changes in the aging structure of society and the patients will be one of the main challenges for surgeons in the coming years. Important factors regarding the outcome of aging patients will be preoperative conditioning, specific age-adapted surgical strategies and the organization of the hospital infrastructure. Nutritional protocols and liquid intake schedules should be taken into account as well as cognitive assessment tools and strategies to protect aging patients from postoperative delirium. The importance of changes in metabolism and the concomitant comorbidities are very similar in most specialty disciplines. The lack of a clear and widely accepted definition of biological age and the missing adaptations of, e. g. complication scores, currently exacerbate the compilation of a resilient survey. In the absence of a reimbursement-system for geriatric medicine it will be very difficult to achieve the necessary structural changes in the treatment regimens for older patients. The establishment of the necessary surgical treatment adapted to the needs of older patients therefore remains a challenging task.