1. Early and late results of cardiac and thoracic aortic surgery in octogenarians: comparison with high-risk younger patients.
- Author
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Kawachi Y, Nakashima A, Kosuga T, Tomoeda H, Nishimura Y, and Toshima Y
- Subjects
- Aged, Female, Follow-Up Studies, Humans, Japan epidemiology, Life Expectancy, Life Tables, Male, Middle Aged, Postoperative Period, Risk Assessment, Severity of Illness Index, Sex Factors, Survival Analysis, Treatment Outcome, Aged, 80 and over, Aorta, Thoracic surgery, Cardiac Surgical Procedures mortality, Cardiac Surgical Procedures statistics & numerical data, Vascular Surgical Procedures mortality, Vascular Surgical Procedures statistics & numerical data
- Abstract
Forty octogenarians (OCTO) undergoing a variety of cardiac and thoracic aortic surgeries using cardiopulmonary bypass (CPB) between 1994 and 2002 were retrospectively studied. The results were compared with those of high-risk younger patients aged less than 60 years (YOUNG) (n=89). All patients had an expected operative mortality of EuroSCORE 5 and over. The EuroSCORE score was 9.9+/-3.3 (range, 5-18) in the OCTO group and 6.8+/-2.3 (range, 5-16) in the YOUNG patients (p<0.0001). There were 4 (10%) and 10 (11%) hospital deaths, respectively (p>0.99). Major postoperative complications occurred in 50% of the OCTO and 36% of the YOUNG patients (p=0.17). There were 10 and 7 late deaths, respectively. Actuarial survival including hospital death was significantly lower in the OCTO group than in the YOUNG (p=0.033). Actuarial survival was significantly higher in female octogenarians than in male (p=0.046). The overall 3-year survival rate was 88+/-8% and 64+/-11%, respectively. Multivariate analysis showed that predictors of late death were male gender (p=0.0005) and a high EuroSCORE (p=0.0010). Cardiac and thoracic aortic surgery using CPB can be performed in octogenarians with an acceptable hospital mortality rate and gratifying medium-term survival results.
- Published
- 2003
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