Related Experiment Videos
Good outcomes from cardiac surgery in the over 70s
A M Zaidi1, A P Fitzpatrick, D J Keenan
1Manchester Heart Centre, The Royal Infirmary, Oxford Road, Manchester M13 9WL, UK. amir@mhc.cmht.nwest.nhs.uk
Heart (British Cardiac Society)
|July 20, 1999
Summary
Cardiac surgery in patients aged 70 years and older shows low early mortality and major morbidity. These findings suggest that age alone should not deter surgical referral, as elderly patients generally achieve good outcomes.
Area of Science:
- Cardiology
- Geriatric Medicine
- Cardiothoracic Surgery
Background:
- This study evaluated early mortality and major morbidity in elderly patients (>/= 70 years) undergoing cardiac surgery.
- A retrospective review analyzed 575 patients from January 1990 to December 1996 at a regional cardiothoracic centre.
Discussion:
- The proportion of elderly patients undergoing cardiac surgery increased significantly from 7.9% in 1990 to 16.5% in 1996.
- While 30-day mortality for isolated coronary artery bypass grafting was higher in the elderly (3.9%) compared to younger patients (1.3%), overall major morbidity remained low.
Key Insights:
- Isolated aortic valve replacement had the lowest mortality (4.3%) in elderly patients.
- Major morbidity rates for stroke (1.9%), acute renal failure requiring dialysis (1.6%), and perioperative myocardial infarction (0.5%) were low across all procedures in this age group.
- Elderly patients undergoing cardiac surgery, including combined procedures, demonstrated favorable outcomes.
Outlook:
- Age should not be a barrier to cardiac surgery referral, as elderly patients typically fare well.
- Further research is needed to assess the cost-effectiveness of cardiac surgery versus conservative management in elderly patients.
- Addressing potential unconscious rationing of healthcare is crucial for equitable referral patterns.