Ziffren S E
J Am Geriatr Soc. 1979 Oct;27(10):433-8. doi: 10.1111/j.1532-5415.1979.tb01722.x.
A comparison was made of the mortality rates for various surgical operations, by age groups and by time periods. The age groups were: under 60, 60-69, 70-79, and 80 or over. The three time periods were: 1951-1955, 1956-1967, and 1967-1977. Only slight improvement was noted in these mortality rates despite the fact that during the 1951-1977 period many improvements were made in anesthesia, surgical techniques, antibiotic therapy, intensive-care units, and presumably the better understanding of disease. Further improvements will depend almost exclusively upon studying the basic problems of old age, chiefly atherosclerosis with its effects on the heart, blood vessels, brain, respiratory system and urinary tract. Unless this is done, there is no prospect of great improvement in operative results, and no basis for believing that the operative risk in the aged is the same as in the young. Unless the physiologic reserves of the aged can be improved, the surgical mortality rates likely will remain static.
对不同外科手术的死亡率按年龄组和时间段进行了比较。年龄组分为：60岁以下、60 - 69岁、70 - 79岁以及80岁及以上。三个时间段分别为：1951 - 1955年、1956 - 1967年以及1967 - 1977年。尽管在1951 - 1977年期间，麻醉、外科技术、抗生素治疗、重症监护病房等方面有诸多改进，而且对疾病的认识可能也有所提高，但这些死亡率仅略有改善。进一步的改进几乎完全取决于对老年基本问题的研究，主要是动脉粥样硬化及其对心脏、血管、大脑、呼吸系统和泌尿系统的影响。除非做到这一点，否则手术结果大幅改善无望，也没有理由认为老年人的手术风险与年轻人相同。除非能改善老年人的生理储备，否则手术死亡率可能会保持不变。
