Related Experiment Videos
Does increasing age have a negative impact on six-month functional outcome after coronary artery bypass?
Mohir H Hedeshian1, Nicole Namour, Elizabeth Dziadik
1Department of Surgery, University of Massachusetts Medical School, Worcester 01655, USA.
Insights
Older patients have lower functional status before and after coronary artery bypass graft (CABG) surgery. However, the functional improvement following CABG is similar across all age groups, indicating age does not impact recovery gains.
Area of Science:
- Cardiovascular Surgery
- Geriatric Medicine
- Quality of Life Research
Background:
- Coronary artery disease (CAD) management has evolved, leading to older patients undergoing coronary artery bypass graft (CABG) surgery.
- The impact of advanced age on functional outcomes post-CABG remains incompletely understood.
Purpose of the Study:
- To evaluate the effect of age on functional outcomes in patients undergoing CABG.
- To compare functional improvement after CABG across different age strata.
Main Methods:
- Functional status was assessed using the Duke Activity Status Index (DASI) in 337 patients undergoing CABG.
- Data were collected at baseline and 6 months post-surgery, with 292 patients providing complete outcome data.
Main Results:
- Patients aged 70 years and older had significantly lower DASI scores at baseline and 6 months post-CABG compared to younger patients.
- Despite lower absolute scores, the change in DASI score at 6 months was comparable between older (>=70 years) and younger (<70 years) patient groups.
- Analysis by age terciles (31-60, 61-71, 72-91 years) showed no significant difference in the 6-month functional improvement.
Conclusions:
- Older patients undergoing CABG present with and maintain a lower functional status post-operatively.
- The degree of functional improvement after CABG is not significantly influenced by patient age.
- These findings suggest that while older adults start and end at a lower functional level, they benefit from CABG to a similar extent as younger individuals.
Background:
Advances in medical care and improvements in catheter-based interventions for coronary artery disease have advanced the age at which patients present for coronary artery bypass graft (CABG) operations. The impact of age on functional outcome after CABG is unclear.
Methods:
Functional outcome was assessed at baseline and at 6 months using the Duke Activity Status Index (DASI) in 337 consecutive patients undergoing primary or redo CABG. Complete functional outcome data were available in 292 patients (86%).
Results:
The mean baseline DASI score was significantly lower in patients > or = 70 years of age (24.8 +/- 14.5 vs 30.9 +/- 17.8, P =.002) and at 6 months (29.6 +/- 16.5 vs 38.0 +/- 17.1, P =.0001); however, the 6-month change in DASI score (7.2 +/- 17.5 in patients < 70 years of age vs 4.9 +/- 14.0 in patients > or = 70 years of age, P =.23) was comparable. When examined in terciles of age, the 6-month change in DASI score was not significantly different (P =.11) in patients aged 31 to 60 years (5.8 +/- 18.0), aged 61 to 71 years (8.7 +/- 15.7), or aged 72 to 91 years (4.0 +/- 14.6).
Conclusions:
These functional outcome results demonstrate that older patients present for CABG at a significantly lower functional level and remain at a significantly lower functional level 6 months after CABG. However, the functional improvement after CABG is not significantly different across age groups.