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Critical analysis of early and late outcomes after isolated coronary artery bypass surgery in elderly patients

, : Critical analysis of early and late outcomes after isolated coronary artery bypass surgery in elderly patients. Annals of Thoracic Surgery 92(5): 1703-1711

The proportion of elderly (?8 years) patients undergoing coronary artery bypass surgery (CABG) is increasing. A retrospective analysis of data, collected by the Australasian Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database Program between June 21 and December 29 was performed. Isolated CABG was performed in 21,534 patients; of these, 1,664 (7.7%) were at least 8 years old (group 1). Patient characteristics, morbidity, and short-term mortality of these patients were compared with those aged less than 8 years (group 2). The long-term outcome of group 1 patients after CABG surgery was compared with an age and sex-matched Australian population. Patients over 8 years old were more likely to be female (36.6% vs 17.3%,p< .1) and presented significantly more often with heart failure, hypertension, and triple-vessel disease (allp< .5). The 3-day mortality was higher in group 1 patients (4.2% vs 1.5%,p< .1). Group 1 patients also had an increased risk of complications, including prolonged (>24 hours) ventilation (14.2% vs 8.2%,p< .1), renal failure (7.3% vs 3.4%,p< .1), and mean intensive care unit stay (6.7 vs 42.5 hours,p< .1). The 5-year survival of elderly patients (73%) was comparable with the age-matched Australian population. Independent risk factors for 3-day mortality in group 1 patients included preoperative renal failure (p= .1), congestive heart failure (p= .14), and a nonelective procedure (p= .16). Elderly patients who undergo isolated CABG have significantly lower perioperative risks than have been previously reported. The long-term survival of these patients is comparable with an age-adjusted population.


PMID: 22051266

DOI: 10.1016/j.athoracsur.2011.05.086

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