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Published on: March 27, 2018
Impact of Gender on Outcome in Octogenarians after Coronary Artery Bypass Grafting
Rouven Berndt1, Bernd Panholzer1, Katharina Huenges1
1Department of Cardiovascular Surgery, University of Schleswig-Holstein, Kiel, Germany.
Insights
Outcomes for octogenarians undergoing coronary artery bypass grafting (CABG) are acceptable. Female gender does not increase risks for morbidity or mortality after CABG surgery in this age group.
Area of Science:
- Cardiovascular Surgery
- Geriatric Medicine
- Health Outcomes Research
Background:
- Cardiac surgery in octogenarians is increasingly common due to rising life expectancy.
- Assessing gender-specific outcomes after coronary artery bypass grafting (CABG) in this population is crucial.
Purpose of the Study:
- To evaluate the impact of gender on the outcomes of octogenarians undergoing isolated CABG.
- To determine if female gender is associated with increased risks after CABG in patients aged 80 and above.
Main Methods:
- Retrospective study of 485 octogenarians (176 females, 306 males) who underwent isolated CABG between 2005 and 2012.
- Analysis of preoperative risk factors, including logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) and EuroSCORE II.
- Comparison of intraoperative parameters (e.g., circulation time, cross-clamp time) and postoperative outcomes (complications, morbidity, 30-day mortality).
Main Results:
- While preoperative risk scores (EuroSCORE and EuroSCORE II) were significantly higher in women, no significant differences were found in preoperative risk factors between genders.
- Intraoperative variables such as distal anastomoses, extracorporeal circulation time, and aortic cross-clamp time were similar for both groups.
- Postoperative complications, major morbidity, and 30-day mortality rates showed no statistically significant differences between female and male octogenarians.
Conclusions:
- Coronary artery bypass grafting in octogenarians yields acceptable mortality rates.
- Female gender is not associated with increased risks for morbidity or mortality following CABG in octogenarians.
- The satisfactory outcomes support the consideration of CABG for octogenarian patients.
Abstract:
Background Increasing life expectancy makes cardiac surgery in octogenarians not very uncommon. In this study, the impact of gender on outcome of octogenarians after coronary artery bypass grafting (CABG) was assessed. Materials and Methods We retrospectively studied 485 octogenarians (176 females: mean age 82.4 ± 2.2 years vs. 306 males: mean age 82.2 ± 2.4 years) who underwent isolated CABG using extracorporeal circulation between January 2005 and December 2012. Results No significant differences were noted between both gender groups with regard to preoperative risk factors. At baseline, the groups differed significantly with respect to mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) (women: 22.3 ± 17.4% vs. men: 17.5 ± 13.3%; p < 0.001). Likewise, EuroSCORE II differs significantly between women and men in our cohort (women: 16.7 ± 11.9% vs. men: 13.9 ± 10.7%; p = 0.008). Intraoperatively, the number of distal anastomoses (3.1 ± 0.9 vs. 3.2 ± 0.8), the mean extracorporeal circulation time (99 ± 31 vs. 102 ± 29 minutes), and the mean aortic cross-clamp time (63 ± 31 vs. 60 ± 19 minutes) were similar in both groups. Postoperatively, no significant differences in complications and major morbidity were observed between the groups. The 30-day mortality (women 8.0 vs. men 9.7%; p = 0.62) were without statistical significance between the groups. Conclusion Outcome of octogenarians after CABG resulted in acceptable mortality. Female gender was not associated with increased risks for morbidity and mortality after surgery. Satisfactory outcomes encourage the offering of surgery in octogenarians.
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