Parsonnet's risk score predicts late survival but not late functional results after aortic valve replacement in octogenarians.
OBJECTIVE
The study aim was to assess whether outcome after aortic valve replacement (AVR) in octogenarians can be anticipated by their preoperative clinical status.


METHODS
Early and late results of 101 consecutive patients operated on for AVR between 1988 and 1998 in the authors' department were reviewed. Data were compared for two patient groups determined by Parsonnet's risk score (PRS) values: group A (n = 42), PRS <30, and group B (n = 59), PRS > or =30.


RESULTS
Hospital mortality was 7.1% in group A and 16.9% in group B (p = NS). Follow up was complete (total 268 patient-years; mean 2.7 years per patient). Five- and eight-year survival rates were 76% and 39% in group A, and 57% and 16% in group B (p <0.05). Late mortality was mainly related to non-cardiac causes. Among 61 survivors on completion of follow up, functional results (mean NYHA class and mean Karnofsky score) were 1.5+/-0.8 versus 1.5+/-0.7 and 61+/-18 versus 61+/-17 in groups A and B, respectively. Among survivors, 24/31 from group A versus 22/30 from group B were still living in their own home.


CONCLUSIONS
These results indicated that the PRS overestimated the operative risk of AVR in octogenarians. PRS also appeared to be related to late survival in these patients, but did not predict any postoperative functional benefits.
Caus
Thierry
T
Service de Chirurgie Cardiaque, CHU Timone Adultes, Marseille, France.
Calon
Daphnée
D
Collart
Frederic
F
Marin
Pablo
P
Seree
Yves
Y
Mesana
Thierry
T
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006334:Heart Function Tests; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000401:mortality*; D006439:Hemodynamics / Q000502:physiology; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D011237:Predictive Value of Tests; D011336:Probability; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome