Short- and long-term outcomes in octogenarians after coronary artery bypass surgery

• Published in: European journal of cardio-thoracic surgery 2012-11, Vol.42 (5), p.e102-e107
• Main Authors: Sen, Bedriye, Niemann, Bernd, Roth, Peter, Aser, Raed, Schönburg, Markus, Böning, Andreas
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Coronary Artery Bypass; Coronary Artery Disease - mortality; Coronary Artery Disease - surgery; Female; Follow-Up Studies; Humans; Incidence; Kaplan-Meier Estimate; Logistic Models; Male; Middle Aged; Multivariate Analysis; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Propensity Score; Quality of Life; Risk Factors; Surveys and Questionnaires; Treatment Outcome
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezs410

OBJECTIVES Coronary artery surgery in octogenarians is carried out with an increasing frequency. We tried to determine short- and long-term outcomes and quality of life after coronary artery surgery in this patient group. METHODS From 3312 patients undergoing isolated coronary artery bypass graft (CABG) surgery in two centres in the years 2004-06, 240 (7.2%) were older than 80 years (mean age 82.3 years, 57.1% male). The octogenarians were analysed regarding perioperative major adverse cardiac and cerebrovascular events (MACCE), late mortality and health-related quality of life (SF-12 questionnaire) and compared with 376 younger patients (mean age 66.8 years, 61.4% male) using propensity score matching. The mean follow-up time of 30-day survivors was 53 months, and follow-up completeness was 97.1%. RESULTS The octogenarians' 30-day mortality rate was 6.8% (vs 1.6% in the younger group). In the multivariate analysis, age was a risk factor for early death [odds ratio (OR) 4.28, 95% confidence interval (CI): 1.59-11.53] and perioperative MACCE (OR 2.78, 95% CI:1.44-5.37). One-year and 3-year survivals were 94.5 and 81.4% in the octogenarians and 98 and 91.3% in the younger group. Four years after surgery, 95.2% of the octogenarians lived alone, with a partner or with relatives, and only 4.0% required permanent nursing care. 83.9% of the octogenarians would recommend surgery to their friends and relatives for relief of symptoms. CONCLUSIONS Octogenarians can undergo CABG surgery with an acceptable risk of early death. Though late mortality is high, late quality of life is comparable with that of younger patients.