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.
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
Judith H
JH
Lichtman
Roger
R
Kapoor
Yun
Y
Wang
Martha J
MJ
Radford
Norrina B
NB
Allen
Harlan M
HM
Krumholz
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