Optimizing Outcomes in Vulnerable Surgical Patients

Major surgery is increasingly performed in older, frail, and multimorbid patients, challenging traditional models of perioperative care. Although advances in anesthesia, surgery, and enhanced recovery pathways have markedly improved perioperative safety, postoperative complications, delayed recovery, and loss of functional independence remain major concerns. Growing evidence suggests that surgical outcomes are determined not only by the procedure itself, but also by preoperative vulnerability, metabolic and nutritional status, and the complex biological response to surgical stress. Improving outcomes in vulnerable patients therefore requires a broader, patient-centered approach spanning the entire perioperative journey, from risk assessment and prehabilitation to personalized perioperative care and recovery.The goal of this Research Topic is to explore innovative strategies to improve outcomes after major surgery, with a particular focus on patients at increased risk of postoperative disabilities and complications. It aims to bring together multidisciplinary perspectives on the identification of patient vulnerability, preoperative optimization and prehabilitation, personalized perioperative management, and postoperative recovery.This Research Topic welcomes original research, systematic and narrative reviews, observational studies, and perspective articles addressing strategies to improve outcomes after major surgery. Areas of interest include, but are not limited to, perioperative risk and vulnerability assessment; frailty and sarcopenia; preoperative optimization and prehabilitation; personalized anesthesia; digital health; enhanced recovery pathways; and strategies promoting postoperative functional and cognitive recovery. Particular attention will be given to multidisciplinary and patient-centered approaches, innovative methods for individualizing care, and studies evaluating patient-reported outcomes, quality of recovery, and longer-term outcomes after surgery. Topic editors: Anne-Françoise Rousseau, Thomas Schricker, Alparslan Turan Source: https://www.frontiersin.org/research-topics/85351/optimizing-outcomes-in-vulnerable-surgical-patients