Coronary artery bypass grafting in octogenarians: an Australian experience
Liam Bibo1, Joshua Goldblatt1,2, Ryan Cohen3,4
1Department of Cardiothoracic Surgery, Fiona Stanley Hospital, Perth, Western Australia, Australia.
ANZ Journal of Surgery
|February 16, 2024
Summary
Coronary artery bypass grafting (CABG) in octogenarians shows increased post-operative complications and longer hospital stays but comparable survival rates to younger patients. CABG remains a safe and viable option for elderly individuals.
Area of Science:
- Cardiovascular Surgery
- Geriatric Medicine
- Outcomes Research
Background:
- Octogenarian patients represent a growing demographic undergoing cardiac procedures.
- Assessing the safety and efficacy of Coronary Artery Bypass Grafting (CABG) in this age group is crucial.
Purpose of the Study:
- To evaluate early and mid-term morbidity and mortality in octogenarian patients after CABG.
- To compare outcomes of CABG in octogenarians versus younger patient cohorts.
Main Methods:
- Retrospective analysis of 901 cardiac surgery patients from February 2015 to September 2019.
- Inclusion criteria: all patients undergoing CABG; exclusion criteria: concomitant valve or aortic procedures.
- Comparison of outcomes between 37 octogenarian patients and younger patients.
Main Results:
- Octogenarians experienced higher rates of post-operative transfusion, acute kidney injury, and atrial fibrillation.
- A higher rate of return to the operating theatre was observed in octogenarians (13.5% vs 4.7%).
- Despite increased morbidity, octogenarians showed no significant difference in hospital readmission, in-hospital mortality, or 1-year mortality compared to younger patients.
Conclusions:
- Coronary Artery Bypass Grafting in octogenarians is associated with increased post-operative morbidity and longer length of stay.
- Survival rates at 24 and 36 months were comparable between octogenarian and younger patient groups.
- CABG is a safe and effective management strategy for octogenarian patients.
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