Changes in presentation and outcomes in cardiac surgery patients aged 70 to 79 years versus patients 80 years or older

Aarne Jyrala, Nicole M. Gatto, Gregory L. Kay

Department of Biostatistics, School of Public Health, University of Los Angeles, Los Angeles, USA.
Department of Cardiothoracic Surgery, Heart Institute at Good Samaritan Hospital, Los Angeles, USA.

DOI: 10.4236/wjcd.2012.23023                

Abstract

Background: To establish which variables between cardiac surgery pts aged 70 - 79 years and 80 years or over are individually different for age group status. Methods: Group 1, 70 - 79 years, n = 351 and Group 2, age 80 or over n = 94. Demographics, operative and hospital outcomes were identified and EuroSCORE (ES) scores applied. Logistic regression uni- and mul-tivariate analysis was used to detect pre- and postop-erative variables which might be independently different between the Groups. Results: Difference (p < 0.05) was noted in (higher in Group 2) patients with CHF, NYHA class, atrial fibrillation, aortic valve disease, both ES algorithms. Group 2 pts had lower ejection fraction and less coronary artery disease. Group 1 had more pts with diabetes. Operative mortality was low (1.7% total) with no difference between the Groups. Length of stay in the postoperative intensive care unit and total hospitalization was equal but Group 2 pts needed more often prolonged stay. Group 2 pts had more postoperative renal failure (p = 0.002) and were more often not discharged home (p = 0.03). Hospital mortality did not reach statistical significance (Group 1 18/5.2%, Group 2 10/10.7%, p = 0.06). Univariate analysis detected 12 pre- and post-operative variables which identified Group status. Multivariate analysis using univariate results detected only diabetes (for Group 1 status) and additive ES (for Group 2 status) to be independently different between the Groups. Conclusions: Elderly pts may be operated with low operative and hospital mortality. Only diabetes and additive ES (=comorbidities) were independently different between the Groups.

Keywords

Cardiac Surgery in Elderly; Differences;Outcomes

Conflicts of Interest

The authors declare no conflicts of interest.

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