Even “minor” surgeries dramatically increase major mortality risk

As I often report, any and all types of surgeries have their risks. And it’s important to weigh those risks before making a decision to undergo a procedure—no matter how “common,” or even “minor,” it may be considered.

In fact, recent research indicates major problems with so-called “minor” surgeries, such as those performed at outpatient surgery centers. A new study published in JAMA Surgery has found that these supposedly “minor” surgeries can end up causing serious complications and even death, especially for frail patients.

Variations on a tragic theme

As you get older, frailty can become a real concern. Hippocrates described it as becoming “overmastered” by disease. It means the body has lost the ability to heal and recover. Even when subjected to minor stress.

Of course, in our modern day and age, surgeons are supposed to assess their patients’ frailty with a clinical tool known as the Risk Analysis Index (RAI). This index notes shortness of breath, unintentional weight loss, and difficulties with bathing, eating, or walking.

But far too many surgeons today plow ahead, performing millions of expensive, invasive procedures each year, even on their clinically frail patients. In fact, on average, about 10 percent of patients who undergo minor surgeries are considered frail.

Increasing death risk up to 180 days post-surgery

For this new study, a team of U.S. researchers analyzed records for more than 400,000 patients who underwent a non-cardiac surgical procedure. About 8.5 percent of the participants were classified as frail and 2.1 percent were classified as very frail.

Researchers tracked outcomes at 30 days, 90 days, and 180 days, post-surgery.

As expected, the frail patients had a much greater risk of suffering a complication—even death—following even low- or moderate-stress procedures. (It’s important to note that most surgical procedures performed at hospitals are classified as causing moderate stress. Whereas surgical procedures performed at outpatient surgery centers are considered to cause low stress.)

But the outcomes tell a different story. Consider this…

Surgeons will typically boast that even “high-risk” procedures—such as heart surgery—carry just a 1 percent risk of death when performed on healthy individuals. (But then again, it’s not healthy people who need procedures!)

But at 30 days post-surgery, all the low-stress and moderate-stress procedures dramatically exceeded that risk when performed on frail and very frail patients.

Specifically, frail patients had a:

  • 2 percent mortality risk after undergoing the lowest-stress operations
  • 5 percent mortality risk after undergoing moderate-stress operations

And very frail patients had a:

  • 10 percent mortality rate after undergoing the lowest-stress operations
  • 19 percent mortality rate after undergoing moderate-stress operations

Plus, just when the patients may have felt as though they were out of danger, they actually faced their greatest risks. In fact, in both frail and very frail patients, mortality rates continued to climb 90 and 180 days post-surgery, reaching as high as 43 percent for very frail patients 180 days after moderate-stress operations.

Clearly, as I routinely warn, and as this study suggests, you should avoid unnecessary, invasive surgeries as you get older. Even if you consider them to be “low risk.”

Fortunately, in many cases you can avoid unnecessary surgeries and stay vibrant, youthful, and healthy well into your 70s, 80s, 90s, and beyond with the simple, natural, healthy aging strategies in my online learning protocol, The Insider’s Ultimate Guide to Outsmarting “Old Age.” To learn more, or to enroll today, simply click here.


“Association of Preoperative Patient Frailty and Operative Stress With Postoperative Mortality.” JAMA Surg. 2020;155(1):e194620. doi:10.1001/jamasurg.2019.4620