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[Coronary bypass surgery in the elderly: characteristics and quality of life]
Y Okamura1, H Iida, Y Mochizuki
1Department of Cardiothoracic Surgery, Dokkyo University School of Medicine, Tochigi, Japan.
Insights
Coronary artery bypass grafting (CABG) in elderly patients (≥70 years) shows similar outcomes to younger patients. Quality of life is generally maintained post-surgery.
Area of Science:
- Cardiovascular Surgery
- Geriatric Medicine
- Surgical Outcomes
Background:
- Elderly patients undergoing coronary artery bypass grafting (CABG) present unique clinical characteristics.
- Comparison of outcomes between elderly and younger CABG patients is crucial for surgical decision-making.
Purpose of the Study:
- To compare the outcomes of CABG in patients aged 70 years or more with those younger than 70.
- To evaluate the quality of life (QOL) in elderly CABG survivors.
Main Methods:
- Retrospective comparison of 66 elderly patients (≥70 years) with 200 younger patients (<70 years) who underwent CABG between November 1991 and December 1996.
- Quality of life assessment using Specific Activity Scale Questionnaires for elderly survivors.
Main Results:
- Elderly patients had higher rates of female gender, smaller body size, left main trunk disease, aortic calcification, and emergency operations.
- No significant differences were observed in hospital mortality, intra-aortic balloon pump (IABP) insertion, or intensive care unit (ICU) length of stay.
- 69% of elderly survivors achieved functional capacity of 5 METs or more; all working patients returned to their jobs, some with reduced workload.
Conclusions:
- CABG can be performed in elderly patients with comparable mortality and morbidity to younger individuals.
- Quality of life is generally well-maintained in elderly patients following CABG.
- Elderly patients represent a viable cohort for CABG with acceptable surgical results and functional recovery.
Abstract:
From November 1991 to December 1996, 66 patients aged 70 years or more underwent coronary artery bypass grafting (CABG). They were compared with a group of 200 consecutive patients aged less than 70 years of age who underwent CABG during the same period. The elderly patients had a higher incidence of female gender, smaller body structure, left main trunk disease, calcification of ascending aorta and emergency operation. However, there were no significant differences between two groups in hospital mortality, IABP insertion or length of stay in intensive care unit. Quality of life (QOL) of the elderly patients was evaluated for all the 58 survivors by means of Specific Activity Scale Questionnaires. Forty of the 58 patients (69%) had functional capacity of 5 METs or more. All the 43 patients who worked before CABG were able return to work, although some patients reduced their workload. We conclude that CABG in elderly patients can be performed with mortality and morbidity similar to those in younger patients. QOL is generally maintained.