[Coronary artery bypass grafting in the elderly: early results]
Tomasz Łapiński1, Bronisław Czech, Barbara Bień
1Klinika Kardiochirurgii Akademii Medycznej w Białymstoku. tomlap@piasta.pl
Insights
For elderly patients undergoing coronary artery bypass grafting (CABG), chronological age may be less important than biological factors for assessing operative risk. This study found similar mortality and morbidity rates between older and younger CABG patients.
Area of Science:
- Cardiovascular Surgery
- Geriatric Medicine
- Health Outcomes Research
Context:
- Coronary artery bypass grafting (CABG) indications are increasing due to an aging global population.
- Existing literature lacks consensus on accurately estimating operative risk for elderly patients undergoing CABG.
- This study addresses the need for better risk stratification in older adults undergoing cardiac surgery.
Purpose:
- To retrospectively analyze postoperative mortality and morbidity in elderly versus younger patients undergoing CABG.
- To compare operative risk assessment using the EuroSCORE protocol between age groups.
- To identify independent risk factors for adverse outcomes in elderly CABG patients.
Summary:
- A retrospective analysis of 300 patients (103 over 65, 197 younger) undergoing CABG was performed.
- Operative risk, assessed by EuroSCORE, was higher in the elderly group, but mortality and morbidity rates were similar between groups.
- Independent risk factors for elderly patients included female gender and gastrointestinal bleeding; diabetes mellitus was a probable contributor to mortality.
Impact:
- Findings suggest biological age, rather than chronological age, is crucial for CABG eligibility in the elderly.
- This research may inform clinical decision-making regarding surgical risk assessment for older adults.
- Highlights the need for individualized risk evaluation in geriatric cardiac surgery patients.
Abstract:
Indications for CABG (coronary artery bypass grafting) procedures are on the rise with ageing population. Because in the world literature there is not consensus on the elderly patients operative risk estimation we have conducted a retrospective analysis of 300 consecutive patients treated at Cardiac Surgery Department of Bialystok University Centre. The postoperative mortality and morbidity rates were assessed in an each case. 103 patients over 65 and 197 younger patients were included to the study. An operative risk was assessed according to EuroSCORE protocol and was higher in the elderly group. Strangely enough, this was not accompanied by higher mortality and morbidity rates, which were rather similar in the two groups. A female gender and an inclination to gastrointestinal bleeding were the independent risk factors in the elderly group. Probably diabetes mellitus is to be held for the higher mortality rate amongst them. In conclusion, the results of the presented investigation suggest that a biological and not a chronological age is essential in the qualification for CABG procedures.
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