Short- and long-term outcome of patients aged 65 and over after cardiac surgery
1Clinical Department of Anesthesiology, Reanimatology and Intensive Care, Referral Centre of the Ministry of Health for Hemodynamic Monitoring in Intensive Care of Surgical Patients, Dubrava University Hospital, Zagreb, Croatia
2 Department of Cardiac Surgery and Transplantation, University Department of Surgery, Dubrava University Hospital, Zagreb
3 Clinical Department of Anesthesiology, Reanimatology and Intensive Care, Clinical Hospital Center Rijeka
4 University Department of Medicine, Dubrava University Hospital, Zagreb
5 Department of Anaesthesia, Barking, Havering and Redbridge University Hospitals NHS Trust, London, United Kingdom
6 Department of Medicine, Medikol Polyclinic, Zagreb
7 Faculty of Medicine, University J.J. Strossmayer Osijek, Osijek
DOI: 10.22514/SV151.042019.10 Vol.15,Issue 1,April 2019 pp.70-74
Published: 23 April 2019
To analyze the short and long-term out-come of patients aged 65 years and over, af-ter cardiac surgery. Over a 12-year period we analyzed 1750 patients with a mean age of 70.09 ± 3.94 years. They were classified into three age groups: between 65 and 69 (n = 709), between 70 and 74 (n = 695) and 75 years and above (n = 346). Follow-up information was obtained by telephone conversation after a 6-month and 3-year period of discharge from the hospital. In-cluded in the follow-up were 1235 patients and an interview was conducted with 501 (40.6%) patients or their next of kin. Even though the in-hospital morbidity was highest in the oldest age group, there were no significant differences between groups (p = 0.051). There was no significant dif-ference between groups in the length of hospital stay. The greatest in-hospital mor-tality was noted in the oldest age group (p = 0.046) compared to patients in the age groups between 65 and 69 and between 70 and 74 years old (p = 0.023 and p = 0.036). In the follow-up study, there was a significantly smaller telephone feedback response in the oldest age group compared to the youngest group (p = 0.003). There were no differences between the groups with respect to mortality and cardiac death after the 6-month and 3-year periods of discharge from hospital.
Our data showed that despite a poor short – and long-term outcome in patients aged 75 and over, all patients had an acceptable operative risk.
elderly; outcome; cardiac surgery
STJEPAN BARISIN,DANIJEL UNIC,HELENA OSTOVIC,MIROSLAV ZUPCIC,TONCI BOZIN,VIKTOR DUZEL,ANA BARISIN,JURE MIRAT. Short- and long-term outcome of patients aged 65 and over after cardiac surgery . Signa Vitae. 2019. 15(1);70-74.
1. Croatian Bureau of Statistics. Census of population, households and dwellings 2011, population by sex and age. (SI-1468. pdf on Internet). Zagreb: Croatia, [updated 17 December 2012; cited 12 July 2013] Available from: http://www.dzs.hr/default_e.htm
2. Croatian Bureau of Statistics. Statistical Yearbook of the Republic of Croatia 2017, (SLJH2017.pdf on Internet). Zagreb: Croatia,[cited 30 June 2017] /update. Available from: http://www.dzs.hr/Hrv_Eng/ljetopis/2017/sljh2017.pdf
3. Nejasmic I, Toskic A. Ageing of the population in Croatia – the current situation and perspectives. Hrv geogr glasnik. 2013;75:89-110.
4. Shapira OM, Kelleher RM, Zelingher J, Whalen D, Fitzgerald C, Aldea GS, et al. Prognosis and quality of life after valve surgery in patients older than 75 years. Chest. 1997;112:885-94.
5. Barisin S, Husedzinovic I, Bradic N, Tonkovic D, Barisin A. Estimation of a new prognostic scoring system in anesthesia: The Cardiac anesthesia risk evaluation score. Neurol Croat. 2003;52(Suppl 3):127-35.
6. Michel P, Roques F, Nashef S. Logistic or additive EuroSCORE for high-risk patients? Eur J Cardiothorac Surg. 2003;23:684-7.
7. Gogbashian A, Sedrakyan A, Treasure T. EuroSCORE: a systematic review of international performance. Eur J Cardiothorac Surg. 2004;25:695-700.
8. Sündermann S, Dademasch A, Praetorius J, Kempfert J, Dewey T, Falk V, et al. Comprehensive assessment of frailty for elderly high-patients undergoing cardiac surgery. Eur J Cardiothorac Surg. 2011;39:33-7.
9. Minne L, Ludikhuize J, de Jonge E, de Rooij S, Abu-Hanna A. Prognostic models for predicting mortality in elderly ICU patients: a systematic review. Intensive Care Med. 2011;37:1258-68.
10. Baskett R, Buth K, Ghali W, Norris C, Maas T, Maitland A, et al. Outcomes in octogenarians undergoing coronary bypass grafting. CMAJ 2005;172:1183-6.
11. Bhamidipati CM, LaPar DJ, Fonner E Jr, Kern JA, Kron IL, Ailawadi G. Outcomes and cost of cardiac surgery in octogenarians is related to type of operation: a multiinstitutional analysis. Ann Thorac Surg. 2011;91:499-505.
12. Trouillet JL, Combes A, Vaissier E, Luyt CE, Ouattara A, Pavie A, et al. Prolonged mechanical ventilation after cardiac surgery: out-come and predictors. J Thorac Cardiovasc Surg. 2009;138:948-53.
13. Shirzad M, Karimi A, Ahmadi A, Marzban M, Tazik M, Aramin H. Predictors and early outcome of prolonged mechanical ventila-tion in contemporary heart valve surgery. Monaldi Arch Chest Dis. 2010;74:22-7.
14. Vives M, Wijeysundera D, Marczin N, Monedero P, Rao V. Cardiac surgery-associated acute kidney injury. Interact Cardiovasc Thorac Surg. 2014;18:637-45.
15. Rhodes A, Evans L, Alhazzani W, Levy MM, Antonelli M, Ferrer R et al. Surviving sepsis campaign: International guidelines for management of sepsis and septic shock: 2016. Crit Care Med 2017; 45:486–552.
16. Marshall JC, Cook DJ, Christou NV, Bernard GR, Sprung CL, Sibbald WJ. Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med 1995;23:1638-52.
17. Kohl P, Kerzmann A, Lahaye L, Gerard P, Limet R. Cardiac surgery in octogenarians: perio-operative and long-term results. Eur Heart J 2001;22:1235-43.
18. Mittermair RP, Muller LC. Quality of life after cardiac surgery in the elderly. J Cardiovasc Surg 2002;43:43-7.
19. Abah U, Dunne M, Cook A, Hoole S, Brayne C, Vale L, et al. Does quality of life improve in octogenarians following cardiac surgery? A systematic review. BMJ Open. 2015;5(4):e006904.
20. Fruitman SD, MacDougall CE, Ross DB. Cardiac surgery in octogenarians: can elderly patients benefit? Quality of life after cardiac surgery. Ann Thorac Surg 1999;68:2129-35.
21. Zaidi AM, Fitzpatrick AP, Keenan DM, Odom NJ, Grotte GJ. Good outcomes from cardiac surgery in the over 70s. Heart 1999;82:134–7.
22. TIME Investigators. Trial of invasive versus medical therapy in elderly patients with chronic symptomatic coronary-artery disease (TIME): a randomised trial. Lancet 2001;358:951-7.
Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.
IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.
Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.
Scopus Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.