Perioperative Management and Clinical Challenges in Elderly Major Surgical Patients

The global population is aging rapidly, and the number of elderly patients undergoing major surgical procedures is steadily increasing. Older adults often present with multiple comorbidities, reduced physiological reserves, and varying degrees of frailty, all of which pose significant challenges to perioperative care. Surgical outcomes in this population are not only influenced by the technical aspects of the procedure but also by multidisciplinary considerations such as preoperative optimization, anesthetic strategy, and postoperative monitoring. Despite growing interest in major geriatric surgery, evidence-based guidelines remain limited, and clinical practice varies widely. There is a pressing need to better understand the complex interplay between age-related physiological changes and surgical risk.

This Research Topic aims to explore the multifaceted aspects of perioperative care in elderly major surgical patients, addressing both clinical challenges and potential strategies for optimization. We seek to highlight key issues such as preoperative frailty assessment, risk stratification, anesthetic planning, intraoperative considerations, and management of postoperative complications such as delirium, infection, and functional decline. Additionally, we welcome contributions examining interdisciplinary care models, enhanced recovery protocols tailored to older adults, and innovations in surgical decision-making for high-risk geriatric populations. By fostering collaboration across specialties—including surgery, anesthesiology, geriatrics, intensive care, and internal medicine—this collection will provide a platform for disseminating both evidence-based practices and novel approaches to improve outcomes in elderly patients. We also encourage discussion of ethical, logistical, and organizational aspects of surgical care in this vulnerable group.

We welcome Original Research articles, Systematic Reviews, Reviews, Case Reports, and Opinion pieces that address perioperative care and clinical outcomes in elderly major surgical patients. To gather further insights in improving perioperative management for the aging population, we welcome submissions addressing themes like:

• Frailty assessment tools
• Perioperative risk prediction
• Anesthetic management
• Postoperative delirium
• Infection control
• Cardiovascular and pulmonary complications
• Enhanced recovery pathways
• Multidisciplinary care frameworks

Submissions focusing on specific major surgical specialties (e.g., general surgery, orthopedics, neurosurgery, cardiovascular surgery) are welcome, provided they align with the overarching theme of geriatric perioperative management. Contributions that address health policy, ethics, and systems-level strategies for improving care delivery to older adults are also encouraged.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• Hypothesis and Theory
• Methods
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Policy and Practice Reviews
• Review
• Study Protocol
• Systematic Review

Keywords: Elderly surgical patients, Perioperative care, Surgical care of the elderly, Postoperative complications, Frailty assessment

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.