Many countries are facing an aging population. As people live longer, surgeons face the prospect of operating on increasingly older patients. Traditional teaching is that with older age, these patients face an increased risk of mortality and morbidity, even to a level deemed too prohibitive for surgery. However, this is not always true. An active 90-year-old patient can be much fitter than an overweight, sedentary 65-year-old patient with comorbidities. Recent literature shows that frailty—an age-related cumulative decline in multiple physiological systems, is therefore a better predictor of mortality and morbidity than chronological age alone. Despite recognition of frailty as an important tool in identifying vulnerable surgical patients, many surgeons still shun objective tools. The aim of this position paper was to perform a review of the existing literature and to provide recommendations on emergency laparotomy and in frail patients. This position paper was reviewed by an international expert panel composed of 37 experts who were asked to critically revise the manuscript and position statements. The position paper was conducted according to the WSES methodology. We shall present the derived statements upon which a consensus was reached, specifying the quality of the supporting evidence and suggesting future research directions.

中文翻译：

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评估和管理紧急剖腹手术中的虚弱：WSES 立场文件

许多国家都面临着人口老龄化问题。随着人们寿命的延长，外科医生面临着对年龄越来越大的患者进行手术的前景。传统的教导是，随着年龄的增长，这些患者面临着更高的死亡率和发病风险，甚至达到了被认为无法进行手术的水平。然而，情况并非总是如此。一位活跃的 90 岁患者可能比一位超重、久坐且患有合并症的 65 岁患者健康得多。最近的文献表明，虚弱——多种生理系统中与年龄相关的累积衰退，因此比单独的实际年龄更能预测死亡率和发病率。尽管人们认识到虚弱是识别易受手术患者的重要工具，但许多外科医生仍然回避客观工具。本立场文件的目的是对现有文献进行回顾，并为紧急剖腹手术和体弱患者提供建议。该立场文件经过了由 37 名专家组成的国际专家小组的审查，他们被要求严格修改手稿和立场声明。该立场文件是根据 WSES 方法进行的。我们将提出达成共识的衍生陈述，明确支持证据的质量并提出未来的研究方向。该立场文件是根据 WSES 方法进行的。我们将提出达成共识的衍生陈述，明确支持证据的质量并提出未来的研究方向。该立场文件是根据 WSES 方法进行的。我们将提出达成共识的衍生陈述，明确支持证据的质量并提出未来的研究方向。