Becher RD, et al. - In order to assess if a structured system of surgical care based on key quality indicators may optimize outcomes, researchers primarily investigated the degree to which hospital emergency operative volume impact mortality for geriatric patients undergoing emergency general surgery (EGS) operations; and secondarily, they sought for procedure-specific hospital volume at which geriatric patients undergoing an emergency operation achieve at or better than average mortality risk. From the California State Inpatient Database (2010-2011), geriatric patients (≥65years) who underwent one of ten EGS operations were identified for this retrospective cohort study. They evaluated in total, 41,860 surgeries at 299 hospitals. Observations revealed significantly improved survival rates for geriatric patients when emergency operations were conducted at hospitals with higher operative volumes. In line with all active Quality Programs of the American College of Surgeons, this study suggests hospital operative volume as a relevant metric of surgical quality for older patients undergoing emergency operations.