The impact of age on 6-month survival in patients with cardiovascular risk factors undergoing elective non-cardiac surgery.
An increasing number of patients aged>or=70 years are presenting for elective non-cardiac surgery. We undertook this study to: (i) compare the nature and distribution of cardiovascular disease (CVD) risk factors in an at risk population of patients aged>or=70 years undergoing elective surgery compared with a younger at risk cohort; and (ii) identify the impact of age and other risk factors on 6-month survival. We conducted a prospective observational study of patients undergoing elective non-cardiac surgery. A total of 1622 patients aged>or=40 years with recognised surgical or patient-specific risk factors for CVD were identified. The patients were divided into two groups; group 1 (aged: 40-69 years) and group 2 (aged>or=70 years). Logistic regression was used to identify the factors associated with 6-month mortality. Odds ratios (OR) and 95% confidence interval (CI) are presented. In hospital, mortality was similar in both groups. However, 6-month mortality in those aged>or=70 years was significantly higher (p=0.001). Cardiovascular symptoms were significantly more common in group 2 (p<0.001) as were cardiovascular-related deaths (p=0.04) at 6 months follow-up. Preoperative cardiovascular preventative therapy was under prescribed in the elderly cohort. Factors independently associated with 6-month mortality were aged>or=70 (OR=3.57, 95% CI: 2.22-5.73), angina (OR=2.0, 95% CI: 1.26-3.20), renal impairment (OR=2.39, 95% CI: 1.17-4.89) also operation type and duration. Despite similar in-hospital mortality, those aged>or=70 years had significantly higher 6-month mortality than the younger surgical cohort. Cardiovascular deaths were significantly higher in patients aged>or=70 years. Effective identification and the management of cardiovascular risk factors may improve 6-month survival.
Naughton
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Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland.
Feneck
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D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D017558:Elective Surgical Procedures / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors
D002317:Cardiovascular Agents