[Impact of age on postoperative events and mortality in cardiac surgery]

The number of "older" patients undergoing cardiac surgery is steadily increasing. In the year 2000, 37% of all patients who underwent a cardiac operation in Germany were > or = 70 years. Looking at data from our institution, we analyzed the impact of age on postoperative events and mortality in cardiac surgery.

Data from 7,048 patients who underwent cardiac surgery in our institution from January 1996 until January 2002 were analyzed. For all patients, EuroSCORE and the corresponding age-stripped value were calculated. All recorded postoperative complications and 30-day mortality were statistically analyzed.

EuroSCORE as well as the age-stripped EuroSCORE showed a significant rise with increasing age in the total number of patients as well as in the patients, who did not die during the first 30 days after the operation. 30-day mortality and the incidence of postoperative complications increased significantly with age. While the EuroSCORE showed a significant age-dependent increase in patients who died within 30 days after the operation, the age-stripped EuroSCORE did not reveal a significant discrepancy in mortality with respect to age.

Our data confirm that the age alone of a patient undergoing cardiac surgery has to be regarded as one of the important independent risk factors for mortality. In order to limit mortality in the steadily growing number of older and multimorbid patients undergoing cardiac surgery, exceptional emphasis has to be put on patient selection and therapeutic measures to improve preoperative status.