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Published on: August 9, 2024

Prolonged intensive care treatment of octogenarians after cardiac surgery: a reasonable economic burden?

Heinz Deschka1, Romy Schreier, Lemir El-Ayoubi

  • 1Department for Cardiothoracic Surgery, Heart and Vessel Center Bad Bevensen, Bad Bevensen, Germany. deschkaheinz@hotmail.com

Interactive Cardiovascular and Thoracic Surgery
|May 28, 2013
PubMed

Insights

Octogenarians undergoing cardiac surgery have higher mortality but similar intensive care unit (ICU) treatment length and costs compared to younger patients. Survivors show comparable quality of life and functional status, justifying their care.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Health Economics

Background:

  • Increasing prevalence of octogenarians undergoing cardiac surgery.
  • Rising intensive care unit (ICU) utilization by elderly patients raises economic and ethical concerns.

Purpose of the Study:

  • To evaluate outcomes and costs associated with prolonged ICU treatment in octogenarians post-cardiac surgery.
  • Compare mortality, ICU length of stay, costs, quality of life (QOL), and functional status between octogenarians and younger patients.

Main Methods:

  • Retrospective analysis of 109 patients requiring ≥5 days ICU treatment after cardiac surgery.
  • Patients divided into Group A (age <80) and Group B (age ≥80).
  • Analysis of operative risk, mortality, ICU treatment duration, costs, 1-year survival, QOL, and functional status.

Main Results:

  • Octogenarians (Group B) had significantly higher hospital mortality (56.5%) than younger patients (31.4%).
  • No significant differences in ICU length of stay or costs were observed between groups.
  • 1-year survival, functional capacity (Barthel index), and QOL (SF-12) were comparable between octogenarians and younger patients.

Conclusions:

  • Advanced age correlates with higher mortality but not prolonged ICU treatment or increased costs after cardiac surgery.
  • Encouraging functional status and QOL in octogenarian survivors suggest their intensive care is justified.
  • Cardiac surgery outcomes for octogenarians warrant consideration of their long-term well-being and resource utilization.
Abstract

Keywords:
Cardiac surgeryIntensive careOctogenariansOutcomesQuality of life

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