Cardiac operations in octogenarians: perioperative risk factors for death and impaired autonomy.
Ann Thorac Surg
; 66(1): 60-7, 1998 Jul.
Article
em En
| MEDLINE
| ID: mdl-9692439
ABSTRACT
BACKGROUND:
With the progressive aging of western populations, cardiac surgeons are increasingly faced with elderly patients.METHODS:
We reviewed the records of 191 consecutive patients aged 80 years or older (mean age, 83 +/- 2.4 years) who underwent a cardiac surgical procedure at our institution from 1991 through 1996.RESULTS:
Ninety-eight patients were men. Preoperatively, 32% of patients were in New York Heart Association class III or IV, and mean left ventricular ejection fraction was 0.55 +/- 0.02. One hundred ten patients (58%) underwent aortic valve replacement, 47 (25%) had coronary artery bypass grafting, 26 (14%) had combined aortic valve replacement and coronary artery bypass grafting, 5 (3%) underwent mitral valve replacement, and 3 (1.6%) had other procedures. Postoperative complications occurred in 69.1% of patients. The hospital mortality rate was 16.2%. Actuarial survival estimates at 1 year, 3 years, and 5 years were 79.2%, 74.9%, and 56.2%, respectively. Multivariate predictors (p < 0.05) of hospital death were preoperative pulmonary hypertension and lower left ventricular ejection fraction. Multivariate predictors of late death were combined aortic valve replacement and coronary artery bypass grafting and female sex. Sixty-four percent of long-term survivors were fully autonomous, and female sex was the only independent predictor of impaired autonomy. Eighty-three percent of survivors were satisfied with their present quality of life.CONCLUSIONS:
Cardiac operations can be performed in octogenarians with a favorable long-term outcome. Earlier referral and intervention is mandatory to improve results in this patient population.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Idoso de 80 Anos ou mais
/
Ponte de Artéria Coronária
/
Implante de Prótese de Valva Cardíaca
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
Ann Thorac Surg
Ano de publicação:
1998
Tipo de documento:
Article
País de afiliação:
França