Cause of late death after cardiac surgery in the very elderly: a single institution experience.
OBJECTIVE
The referrals of elderly for cardiac surgery are increasing. The aim of this retrospective study is to review the long-term survival and to identify causes of late death in elderly after cardiac surgery.


METHODS
Between 1990 and 1993, 130 octogenarians underwent cardiac surgery in our department. A majority (88%) had elective surgery. One hundred and nine patients (84%) were in New York Heart Association functional class III or IV, preoperatively. Mean follow-up time was 5.4 +/- 2.5 years (range 0-10 years). Follow-up was 100% complete.


RESULTS
Hospital mortality was 3.8% (5/130). Actuarial survival at 1 and 5 years were 90.0 +/- 2.6% (n = 117) and 62.3 +/- 4.3% (n = 81), respectively. Forty-six operative survivors died from cardiac-related death during follow-up. Multivariate predictors of postoperative death were higher age, poor left ventricular ejection fraction, preoperative renal insufficiency and combined surgical procedures.


CONCLUSIONS
Our results in this paper indicate that cardiac-related mortality represents the majority of late deaths after cardiac surgery in octogenarians.
Sjögren
Johan
J
Department of Cardiothoracic Surgery, Heart and Lung Division, University Hospital, Lund, Sweden. johan.sjogren@thorax.lu.se
Thulin
Lars I
LI
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D011788:Quality of Life; D051437:Renal Insufficiency; D012189:Retrospective Studies; D013318:Stroke Volume; D011795:Surveys and Questionnaires; D017741:Survivors; D013997:Time Factors