The dilemma of perioperative shared decision-making in an octogenarian with advanced cancer: fracture after stent placement and delayed palliative care.

This report presents the perioperative course of an elderly patient with advanced cancer who suffered an unexpected fracture within 15 days after cardiac stent implantation. The case underscores the practical challenges in clinical shared decision-making when multiple high-risk conditions converge, including limitations in applying existing guidelines and a delayed integration of palliative care. Therefore, it is essential to establish a systematic preoperative assessment protocol, identify palliative care needs, and promote patient-goal-directed clinical decision-making—a process in which the anesthesiologist can serve as a central coordinator.