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11. Hide IG, Pike EE, Uberoi R: Lumbar hernia: a rare cause of Large bowel obstruction. Postgrad Med J 1999,75(882):231–232.PubMedCentralPubMed 12. Astarcioğlu H, Sökmen S, Atila K, Karademir S: Incarcerated inferior lumbar (Petit’s) hernia. Hernia 2003,7(3):158–160. Epub 2003 Apr 10PubMedCrossRef 13. Light D, Gopinath B, Banerjee A, Ratnasingham K: Incarcerated lumbar hernia: a rare presentation. Ann R Coll Surg Engl 2010,92(3):W13-W14.PubMedCrossRef 14. Teo KA, Burns E, Garcea G, Abela JE, McKay CJ: Incarcerated small bowel within a spontaneous lumbar hernia. Hernia 2010,14(5):539–541. Ro 61-8048 supplier Epub 2009 Nov 5PubMedCrossRef Competing interests The authors declare that they have no competing interests. Authors’ contributions MF, Conceived and wrote the manuscript. PF, Collected the data. AE, MNN, MS critically revised the manuscript. Overall

responsibility MF. All authors read and approved the final manuscript.”
“Introduction It is estimated that the majority of people born in developed nations during the 21st century will live to their 100th birthdays [1]. Both the increased number of elderly and the inherent complexity of their health have resulted in increased demands on the health care system [1–5]. Comparative studies across nations have suggested that increased survival to the highest ages is associated with worse health [1]. Overall, the current population will be living longer with more health problems than in the past. The very elderly (age ≥ 80 years) often suffer from frailty. Frailty is associated with advanced age, but is also influenced by comprehensive determinants including medical comorbidity,

nutritional status, mental health, social support, and cognition [6]. Neither a single definition nor measure of frailty exists; however, there is consensus that very elderly individuals have an increased risk of adverse outcomes from physiological stress and disease. A growing body of evidence on the outcome of elective operative management Bay 11-7085 of very elderly patients has become available over the last decade [6–12]. However, there are limited data on the outcome of very elderly patients undergoing emergency general surgical procedures [6, 13–15]. While elective surgical care affords the benefit of comprehensive geriatric assessment and the pre-operative optimization of comorbid states, emergency surgery differs in that there is limited time for information collection (including goals of care). The baseline health, mental, and social status of elderly patients who present with acute surgical emergencies is often unknown and comorbidities under recognized.