Inclusion Criteria:  45-64 years of age with at least one risk factor, or ≥65 years of age; undergoing elective noncardiac same-day surgery under regional or general anaesthesia;  Exclusion Criteria:  undergoing surgery under local anaesthesia or surveillance only; planned duration in the operating room is estimated to be less than 60 minutes; intervention does not require the presence of an anesthesiologist; procedure is performed by a nonsurgical specialty (e.g., endoscopy by gastroenterology, bronchoscopy by pneumology, radiotherapy or radiology procedures); intervention is an ophthalmologic procedure; previously enrolled in the VALIANCE study patients who do not consent to participate in the study