Being an elderly woman: is it a risk factor for morbidity after coronary artery bypass surgery?
OBJECTIVE
Despite the refinements in surgical techniques and postoperative care, elderly women still have a higher prevalence of postoperative morbidity.


METHODS
The outcomes of 112 elderly women (>80 years) who underwent an elective CABG procedure were compared with those of males operated during the same time interval (n, 164).


RESULTS
Median age of female and male patients were 82 and 83 years, respectively. Mean number of grafts did not differ significantly (3.7+/-0.8 vs 3.9+/-0.3, p=0.4) between groups. Overall early operative mortality rate was 8.6% (24 of 276 patients); 8.9% (10 of 112 patients) for female and 8.5% (14 of 164 patients) for male patients (p=0.1). Postoperative complications including prolonged ventilation time (13.4% in females vs 8.5% in male, p<0.01), atrial fibrillation (40% in females vs 33% in males, p=0.01), sternal reclosure (8% in females vs 4.2% in males, p=0.01), pneumonia (5.3% in females vs 3% in males, p=0.03), leg wound infection (11.7% in females vs 2.4% in males, p<0.001), renal dysfunction (10.7% in females vs 7.3% in young patients, p=0.02) have been found to be significantly higher in elderly women. Mean intensive care unit (3.2+/-1.1 days in females vs 1.6+/-0.4 in males, p=0.03), and hospital stays (13.6+/-2.1 days in females vs 9.1+/-1.2 in males, p=0.02) were also longer in female patients. Five-year survivals including all deaths for female and male patients were 57% and 62%, respectively.


CONCLUSIONS
In elderly women, revascularization procedures can be done with acceptable mortality rates; but these patients are still associated with a higher prevalence of postoperative morbidity when compared with the male counterparts. Therefore, these patients have to be very carefully evaluated preoperatively and their postoperative care should be more comprehensive to reduce the incidence of postoperative complications.
Basaran
Murat
M
Cardiovascular Surgery Clinic, Goztepe Safak Hospital, Istanbul, Turkey. dr_murat_basaran@yahoo.com
Selimoglu
Ozer
O
Ozcan
Hamiyet
H
Ogus
Halide
H
Kafali
Eylul
E
Ozcelebi
Cuneyt
C
Ogus
Temucin Noyan
TN
D000367:Age Factors; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications; D012737:Sex Factors; D016896:Treatment Outcome