Each year, approximately 50 million inpatient surgical operations are performed in the United States as well as a similar number of ambulatory procedures. An increasing number of these patients are elderly or have significant comorbid medical disease. However, operative mortality and morbidity have declined due to improvements in surgical, anesthetic, and monitoring techniques. The traditional preoperative roles of the medical consultant or primary care provider include evaluating the severity and stability of medical conditions, assessing the risk of medical complications, determining whether further preoperative risk stratification testing is indicated, and recommending measures to reduce the risk of perioperative complications. The consultant may also be asked to manage medical aspects of patients' postoperative care, including evaluation and treatment of medical complications.
et al. The impact of pre-operative comprehensive geriatric assessment on postoperative outcomes in older patients undergoing scheduled surgery: a systematic review. Anaesthesia. 2014 Jan;69(Suppl 1):8–16.