Temporal trends of outcomes for nonagenarians undergoing coronary artery bypass grafting, 1993 to 1999.
Temporal trends in length of stay, discharge disposition, and long-term mortality outcomes were examined in nonagenarians who underwent coronary artery bypass grafting (CABG) from 1993 to 1999. A total of 4,224 fee-for-service Medicare beneficiaries (2,068 women, 2,156 men) aged>or=90 years underwent CABG from 1993 to 1999. The number of procedures increased from 325 in 1993 to 883 in 1999 among all fee-for-service Medicare patients aged>or=65 years. Approximately half of CABG procedures were performed on women each year. The mean length of stay decreased from 18.0+/-10.8 to 13.3+/-8.8 days from 1993 to 1999 but remained longer for women (p<0.001). A greater percentage of women than men were discharged to skilled nursing facilities. The overall crude mortality rates remained relatively stable at 13.5% at 30 days and 59.0% at 5 years. Men and women had comparable short-term mortality outcomes, but men had higher mortality rates for 2- to 5-year outcomes. In conclusion, the number of CABG procedures in nonagenarians is increasing, with a substantial portion attaining survivorship that is equivalent to projected life expectancy.
Lichtman
Judith H
JH
Section of Chronic Disease Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, and Center for Outcomes Research and Evaluation, Yale New Haven Hospital, Connecticut, USA. judith.lichtman@yale.edu
Kapoor
Roger
R
Wang
Yun
Y
Radford
Martha J
MJ
Allen
Norrina B
NB
Krumholz
Harlan M
HM
D000367:Age Factors; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D015996:Survival Rate / Q000639:trends*; D016896:Treatment Outcome