Quality of life in the very elderly after cardiac surgery: a comparison of SF-36 between long-term survivors and an age-matched population.
BACKGROUND
Octogenarians are the fastest growing section of the population in Western countries. Since health care resources are limited, there is a need for critical evaluations of the long-term surgical outcome and quality of life in the elderly.


OBJECTIVE
Our aim was to assess the quality of life and long-term survival after cardiac surgery in the very elderly.


METHODS
Between 1990 and 1993, 117 octogenarians underwent aortic valve replacement, coronary artery bypass grafting or combined surgery at our department. Forty-one patients were still alive at the time of follow-up (mean 8.3 +/- 1.9 years). Thirty-nine of the 41 long-term survivors (95%) answered a quality of life questionnaire (SF-36). The scores were compared with an age-matched population.


RESULTS
The overall survival at 1, 5 and 9 years was 92.3 +/- 2.5, 65.0 +/- 4.4 and 37.9 +/- 5.2%, respectively. A significant difference was identified between the scores of our patients and the general Swedish octogenarians in two SF-36 headings (Bodily Pain and Physical Functioning). Our patients indicated lower physical function, but less pain in comparison with the general aged population. There was no significant difference in six of the eight SF-36 headings.


CONCLUSIONS
The overall long-term survival was similar to Swedish octogenarians. Late postoperative quality of life in our long-term survivors was comparable to an age-matched population. Our findings support the view that a selected population of elderly may undergo open heart surgery with good long-term quality of life.
Department of Cardiothoracic Surgery, Heart and Lung Division, University Hospital, SE-221 85 Lund, Sweden. johan.sjogren@thorax.lu.se
Johan
J
Sjögren
Lars I
LI
Thulin
D000368:Aged; D000369:Aged, 80 and over / Q000523:psychology*; D016022:Case-Control Studies; D005260:Female; D006331:Heart Diseases / Q000523:psychology* / Q000601:surgery; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D017741:Survivors / Q000523:psychology*; D013903:Thoracic Surgery / Q000379:methods