Coronary bypass surgery in patients aged 70 years and over: mortality, morbidity, length of stay and hospital cost.
The objective of this investigation was to compare the outcome of isolated coronary artery bypass grafting surgery in patients > or = 70 years with those < 70. The cardiac surgery database of the Institute was used to obtain the characteristics of patients undergoing coronary artery bypass grafting between January 2000 and September 2001. The patients were divided into those > or = 70 years of age and those < 70 years old. A Parsonnet risk score was determined for each patient for the analysis of mortality, length of stay and hospital charges. During the study period, 1594 cases of isolated coronary artery bypass grafting were carried out. 184 (11.5%) cases were performed in the older group. The 30-day mortality for patients aged 70 and over was 7 (3.3%) out of 184 while that of patients < 70 years of age was 47 (3.8%) out of 1410 (p < 0.740). The overall hospital mortality was 10 (5.4%) of 184 and 53 (3.8%) of 1410 (p < 0.272) respectively. Apart from a higher incidence of wound infection in elderly patients, the frequency of other major complications was comparable in both groups. The average length of postoperative stay for the elderly patients was 10.4 +/- 0.9 days compared to 8.7 +/- 0.2 days for the younger group (p < 0.049). The mean hospital charge in patients > or = 70 was RM 25,160.38 +/- 1656.75 whereas for patients < 70, it was RM 21,801.47 +/- 308.91 (p < 0.048). This study supports the continued performance of coronary artery bypass grafting in patients > or = 70 years. Advanced age alone should not deter a cardiac surgeon from offering such a potentially beneficial intervention.
Ng
Chye-Yew
CY
General Surgery, Royal Infirmary of Edinburg, Scotland. cyng@excite.com
Ramli
Mohd Faizal
MF
Awang
Yahya
Y
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D006488:Hemostasis, Surgical; D017722:Hospital Charges; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D015996:Survival Rate; D013997:Time Factors