Assessment of the risk of surgery and anesthesia in elderly and elderly patients: the evolution of approaches

The lecture delivered for the «Russian oncologists’ school» is devoted to the history and present surgical and anesthestic risk asessment «state of the art», thansformed to the risk management concept during the last decades. Special attention was paid to various risk assessment tools, including traditional scales and score systems, functional tests, peresonalized prediction of the most probable perioperative critical incidents and complications and safe biophysical modelling of physiological responses to real challenges in the OR and ICU. The possibility to move from simple exclusion high risk patients from elective surgery plan to goal directed prehabilitation focused on most probable critical incodents and complications prevention is discussed and underlined.