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The octogenarians--a new challenge in cardiac surgery?
U Klima1, G Wimmer-Greinecker, R Mair
1Surgical Department I, AKH Linz, Austria.
The Thoracic and Cardiovascular Surgeon
|August 1, 1994
Summary
Octogenarians undergoing open heart surgery face risks, but multivariate analysis identified key predictors of morbidity and mortality, suggesting acceptable outcomes for this age group.
Area of Science:
- Cardiothoracic Surgery
- Geriatric Medicine
- Outcomes Research
Background:
- Open heart surgery in octogenarians presents unique challenges due to age-related physiological changes.
- Assessing perioperative risks is crucial for optimizing outcomes in elderly cardiac patients.
Purpose of the Study:
- To analyze the early postoperative outcomes of octogenarians undergoing open heart surgery.
- To identify independent risk factors influencing morbidity and mortality in this patient population.
Main Methods:
- Retrospective analysis of 75 consecutive octogenarians (mean age 81.7 years) who underwent open heart surgery.
- Multivariate analysis to determine independent predictors of morbidity and mortality.
- Categorization of procedures included coronary artery bypass grafting, valve replacement, and combined procedures.
Main Results:
- Age, New York Heart Association functional class, operative procedure, aortic cross-clamp time, and total bypass time were independent predictors of morbidity and mortality (p < 0.05).
- The study reported 6 postoperative deaths (8% mortality rate).
- Common postoperative complications included hemorrhage, stroke, unstable sternum, pneumothorax, and urinary tract infection.
Conclusions:
- Octogenarians can achieve acceptable outcomes from open heart surgery.
- Risk stratification using identified independent predictors can aid in surgical decision-making for elderly patients.