Cardiac surgery in 260 octogenarians: a case series

• Published in: BMC anesthesiology Vol. 15; no. 1; p. 15
• Main Authors: Scandroglio, Anna Mara, Finco, Gabriele, Pieri, Marina, Ascari, Roberto, Calabrò, Maria Grazia, Taddeo, Daiana, Isella, Francesca, Franco, Annalisa, Musu, Mario, Landoni, Giovanni, Alfieri, Ottavio, Zangrillo, Alberto
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 26.01.2015; BioMed Central
• Subjects: Aged, 80 and over; Analysis; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - mortality; Cardiac Surgical Procedures - statistics & numerical data; Care and treatment; Diagnosis; Female; Health aspects; Hospital Mortality; Humans; Italy - epidemiology; Lung diseases, Obstructive; Male; Medical research; Medicine, Experimental; Outcome Assessment (Health Care) - statistics & numerical data; Physiological aspects; Postoperative Complications - epidemiology; Retrospective Studies; Risk factors; Italy; Anesthesia; Intensive care; Octogenarian; Cardiac surgery; Complications; Mortality
• ISSN: 1471-2253; 1471-2253
• DOI: 10.1186/1471-2253-15-15

The elderly undergo cardiac surgery more and more frequently, often present multiple comorbidities, assume chronic therapies, and present a unique physiology. Aim of our study was to analyze the experience of a referral cardiac surgery center with all types of cardiac surgery interventions performed in patients ≥80 years old over a six years' period. A retrospective observational study performed in a university hospital. 260 patients were included in the study (3.5% of the patients undergoing cardiac surgery in the study period). Mean age was 82 ± 1.8 years. Eighty-five percent of patients underwent elective surgery, 15% unplanned surgery and 4.2% redo surgery. Intervention for aortic valve pathology and coronary artery bypass grafting were performed in 51% and 46% of the patients, respectively. Interventions involving the mitral valve were the 26% of the total, those on the tricuspid valve were 13% and those on the ascending aortic arch the 9.6%. Postoperative low output syndrome was identified in 44 patients (17%). Mortality was 3.9% and most of the patients (91%) were discharged from hospital in good clinical conditions. Hospital mortality was lower in planned vs unplanned surgery: 3.8% vs 14% respectively. Chronic obstructive pulmonary disease (OR 9.106, CI 2.275 - 36.450) was the unique independent predictor of mortality. Clinicians should be aware that cardiac surgery can be safely performed at all ages, that risk stratification is mandatory and that hemodynamic treatment to avoid complications is expected.