[Cardiac surgery in the elderly: comparison of medium-term clinical outcomes in octogenarians and the elderly from 75 to 79 years].
OBJECTIVE
The age of patients undergoing cardiac surgery has increased in recent years. Our aims were to investigate the medium-term clinical outcomes of surgery in octogenarians and to compare them with outcomes in other elderly individuals of a less advanced age.


METHODS
We investigated early mortality, the incidence of postoperative complications, medium-term survival and factors associated with these parameters in 589 consecutive elderly patients undergoing surgery: 140 were octogenarians aged 80-87 years (group I) while 449 were aged between 75 and 79 years (group II).


RESULTS
The two groups were similar. There was no difference in mortality (10.0% in group I vs. 10.9% in group II) or in the incidence of postoperative complications (22% in group I vs. 30% in group II). Emergency surgery, combined surgery and pulmonary hypertension were all independent predictors of mortality and of major postoperative complications. The 5-year survival rate was 79% in group I and 65% in group II (P=.832) and the cardiac event-free survival rate was 75% in group I and 64% in group II (P=.959). Overall, 97% of patients in both groups were in functional class I or II. The additive EuroSCORE and preoperative atrial fibrillation were both associated with increased mortality during follow-up. Being an octogenarian was not a predictor (hazard ratio=0.78; 95% confidence interval, 0.51-1.21; P=.373).


CONCLUSIONS
In selected octogenarians, cardiac surgery gives similar results to those obtained in other elderly individuals of a less advanced age. The medium-term survival rate and quality of life are good. Pulmonary hypertension, emergency surgery and combined surgery all increased risk in these patients.
López-Rodríguez
F Javier
FJ
Servicio de Cirugía Cardiaca, Hospital Universitario de Salamanca, Salamanca, España. jlopezrodri@wanadoo.es
González-Santos
José M
JM
Dalmau
M José
MJ
Bueno
María
M
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D016896:Treatment Outcome