ABSTRACT
Aerobic fitness declines with age, and any impairment of functional capacity is associated with increased morbidity and mortality in major surgery with the occurrence of even a single post-operative complication having a significant bearing upon mortality at 30 days, 1 year and 5 years. Respiratory complications are one of the leading causes of mortality and morbidity in the surgical population. Patients are screened for respiratory disease pre-operatively, and they may be limited in exercise capacity due to shortness of breath, or co-morbid conditions such as chronic obstructive pulmonary disease. Anaemia is common in the pre-operative surgical population and is independently associated with increased morbidity and mortality, the likelihood of intensive care admission and the duration of hospital stay. Immediate post-operative hyperglycaemia is known to interfere with neutrophil function in several diverse ways including impaired chemotaxis, phagocytosis, and reduced respiratory burst preventing early killing of bacteria that may have entered the wound at the time of surgery.
