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

摘要

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.