Clinical features of elderly patients submitted to coronary artery bypass graft

To describe the clinical features as well as morbidity and mortality of elderly patients submitted to coronary artery bypass graft (CABG).

Randomized, single-center, observational study.

A prospective study was carried out in a tertiary referral teaching hospital (Heart Institute-Brazil). A total of 220 inpatients submitted to elective CABG were evaluated and data collected from the pre-, intra- and postoperative periods.

The patients were assessed according to the Geriatric Depression Scale. A diagnosis of delirium was determined according to DSM-IV criteria.

Of these 220 patients 64.5% were males and 35.5% females. The mean age was 71 years. The most important preoperative findings were a higher incidence of comorbidities such as hypertension (73%), diabetes mellitus (35%), dyslipidemia (27%), and previous myocardial infarction (41%). The majority of patients were found to have three or more vessels obstructed at angiography (74%). The major intraoperative findings were that a high number of the patients received more than 3 grafts (74%). A large proportion (72%) of patients needed a blood transfusion and the overall incidence of clinical complications was 33%. The overall postoperative mortality rate for this observational study was 5%. A large number of patients presented complications (56%) such as hypotension (22%), atrial fibrillation (22%), and delirium (34%).

Although elderly patients have a somewhat increased, however acceptable, operative mortality rate, we believe that this patient group can benefit from CABG.