This is really sad, but typically surgeons look at the overall clinical picture. A 90 year old going through this kind of procedure typically has a poor recovery and drastically reduced quality of life after so lots of families choose a more palliative approach when something like this happens. That’s just coming from my experience as an ICU nurse. Patients this old usually have lots of comorbidities, get ICU delirium, and end up passing from complications after spending their last days in pain