Despite improvements in surgical procedures and post-operative care, some patients do not regain their preoperative function. About 30% of those who have had major surgery, experiences postoperative complications. A significant amount of homeostatic disturbance occurs after surgery. The surgical stress response is characterized by catabolism and increased oxygen demand. The extent and duration of the stress response are proportionate to the magnitude of surgery and the associated risk of developing postoperative complications. After surgery, there is a significant decline in the patient's quality of life and physical function even in the absence of complications or comorbidities. Patients who experience postoperative complications within 30 days of surgery have a decreased long-term survival rate. Major surgery results in tissue damage, cardiovascular effort, and decline in physical activity with loss of muscular mass, pulmonary and decubitus complications.

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