Open-heart surgery in a growing geriatric population: patient selection and risk factors to be considered.
OBJECTIVE
This report describes our experience with cardiac surgery in elderly patients and aims to ascertain predictors of poor outcome.


METHODS
Five hundred and ninety-eight (598) consecutive patients aged 75 years and older underwent cardiac surgery at the Department of Cardiothoracic Surgery, University Hospital of Lund, Sweden, between January 1980 and December 1993. There were 324 men (54%) and 274 women (46%); their age varied between 75 and 91 years (mean age +/- SD, 77.8 +/- 2.6 years). One hundred and twenty-nine patients underwent aortic, mitral or combined valve replacement, 273 patients underwent exclusive coronary revascularization (CABG) alone and 109 underwent a surgical procedure which included valve replacement and concomitant CABG. The remainder (87 patients) underwent other, more complex surgical procedures.


RESULTS
The 30-day or in-hospital mortality rate was 5.5% (0.8% for valve replacement, 5.1% for CABG, 5.5% for valve replacement with concomitant CABG, and 12.6% for other procedures). Concomitant severe diseases occurred in 34.9% of the patients. All surviving patients were evaluated during June 1994. None of the patients was lost to follow-up. The 566 long-term survivors have been followed for an average of 23.0 months (median 21; range 1-53 months). Late mortality was 12.0% in the 566 hospital survivors. Only 17 patients experienced late complications (after hospital discharge), as an adverse effect linked to heart surgery.
Thulin
L I
LI
Department of Cardiothoracic Surgery, University Hospital, Lund, Sweden.
Sjögren
J L
JL
D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data*; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data; D013548:Sweden / Q000453:epidemiology