title: Is age an independent determinant of mortality in cardiac surgery as suggested by the EuroSCORE?
abstract: BACKGROUND
  The proportion of older patients in cardiac surgery is continuously increasing. 37% of patients undergoing heart surgery in Germany in the year 2000 were 70 years of age and older. We have studied the role of age as a determinant of mortality in cardiac surgery in our institutional patient population.
  
  
  METHODS
  We have calculated the EuroSCORE and the corresponding age-adjusted EuroSCORE in 8769 patients who underwent heart surgery between January 1996 and January 2002 and collected the information on the occurrence of postoperative complications and 30-days mortality.
  
  
  RESULTS
  The multimorbidity increased with ascending age. Both the EuroSCORE and the age-adjusted EuroSCORE values increased significantly with age in the whole group of patients as well as in the group of patients who were alive 30 days after heart surgery. The incidence of postoperative complications and 30-days mortality increased significantly with age. In patients who died within 30 days after surgery, the EuroSCORE increased significantly with age, whereas the age-adjusted EuroSCORE did not. The occurrence of diabetes mellitus, arterial hypertension and atrial fibrillation, i.e., the risk factors not considered by the EuroSCORE, exhibited a significant age dependence in our patients. The univariate analysis identified the significant dependence of 30-days mortality on diabetes and atrial fibrillation. The stepwise logistic regression analysis showed the dependence of mortality on diabetes.
  
  
  CONCLUSIONS
  On the background of the well-known age-dependent structural and functional changes of different body organs, our data show that age is a significant risk indicator in cardiac surgery, strongly correlating with morbidity and mortality. Consequently, special preventive and therapeutic measures are required in clinical environment in the case of elderly patients undergoing cardiac surgery.
authors.affiliation: Clinic of Thoracic and Cardiovascular Surgery, Heart Institute Lahr/Baden, Lahr, Germany. a.mortasawi@heart-lahr.com
authors.forename: Amir
authors.initials: A
authors.lastname: Mortasawi
authors.forename: Bert
authors.initials: B
authors.lastname: Arnrich
authors.forename: Ulrich
authors.initials: U
authors.lastname: Rosendahl
authors.forename: Inez
authors.initials: I
authors.lastname: Frerichs
authors.forename: Alexander
authors.initials: A
authors.lastname: Albert
authors.forename: Jörg
authors.initials: J
authors.lastname: Walter
authors.forename: Jürgen
authors.initials: J
authors.lastname: Ennker
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000401:mortality* / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012306:Risk