Single-institution effectiveness assessment of open-heart surgery in octogenarians

• Published in: European journal of cardio-thoracic surgery Vol. 12; no. 2; pp. 285 - 290
• Main Authors: DE MOL, B. A. J. M, KALLEWAARD, M, LEWIN, F, VAN GAALEN, G. L, VAN DEN BRINK, R. B. A
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Science B.V 01.08.1997; Elsevier Science
• Subjects: Aged; Aged, 80 and over; Analysis of Variance; Biological and medical sciences; Coronary Artery Bypass - economics; Coronary Artery Bypass - methods; Coronary Artery Bypass - mortality; Costs and Cost Analysis; Female; Heart Valve Prosthesis - economics; Heart Valve Prosthesis - methods; Heart Valve Prosthesis - mortality; Humans; Logistic Models; Male; Medical sciences; Netherlands; Odds Ratio; Postoperative Complications - mortality; Quality of Life; Retrospective Studies; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Survival Rate; Netherlands; Human; Age 80-89; Heart; Prognosis; Elderly; Surgery
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/S1010-7940(97)00103-6

OBJECTIVE: To determine short- and long-term outcome of open-heart surgery in octogenarians. METHODS: We reviewed the medical charts of 130 consecutive octogenarians undergoing open-heart surgery. Patients with significant comorbidity were excluded from the study. The effect of cardiac and operative risk factors on mortality and morbidity was evaluated. General practitioners and cardiologists were contacted in order to obtain information on the patients' current medical and functional status. RESULTS: Operative mortality for valve replacement (VR) and coronary artery bypass grafting (CABG) was 11.5%. Four-year survival was 73.5% with 75.9% still living independently. The relative risk for operative mortality was 4.3 in case of extracorporeal bypass time exceeding 95 min and 3.6 in case of significant left main stem disease. The risk of late death increased 2.5 times at a left ventricular ejection fraction lower than 50%. CONCLUSIONS: Our data match the results of similar studies involving large numbers of patients. When a multicenter data bank is missing, the evaluation of a relatively small patient group can yield information that may be as useful to patient and physician as information obtained by large studies. Open-heart surgery in octogenarians carries an acceptable mortality risk and its effectiveness in terms of improved quality of life is good.