Risk factors in septuagenarians or elderly patients undergone coronary artery bypass grafting and or valves operations.
OBJECTIVE
Septuagenarians or older patients needing heart surgery has increased in whole world. The objective of study is to know the characteristics of this group of patients and determine the risk factors for operative morbidity.


METHODS
We revised the medical records of 783 patients undergone heart valve surgery, myocardial revascularization or both between 2002 and 2007. The patients were divided in 'control group' (<70 years) 'septuagenarian group' (70 years old or more).


RESULTS
One hundred ninety seven patients were at least 70 years old (mean age 74.1+/-3.9) and 61% were male. In the control group the mean age was 52.1+/-11.7 and 54% were male. In the septuagenarians group it was significantly higher the proportion of patients suffering from peripheral vascular disease (9% versus 5%, P=0.019), carotid artery obstruction (5% versus 2%, P=0.026), unstable angina (17% versus 9%, P=0.018). In both groups coronary artery bypass surgery prevailed. In the septuagenarian group 41% of the patients had a least one morbid event, versus 22% of the patients in the control group (P<0.001). Postoperative bleeding, pulmonary complications, mediastinitis, need of vasopressors, renal dysfunction and strokes were significantly higher in the septuagenarian group. The mortality was higher in the septuagenarian (19% versus 8.5%, P<0.001). The logistic regression revealed that COPD (OR: 8.6), EF < 35% (OR: 7,1), non-elective operation (OR: 17,2) and cardiopulmonary bypass time >120 min (OR: 3,4) were predictive of hospital mortality in septuagenarian or older patients.


CONCLUSIONS
The hospital mortality of septuagenarians or elderly is significantly higher than younger patients.
Alves Júnior
Lafaiete
L
Disciplina de Cirurgia Cardiovascular e Torácica, Faculty of Medicine of Ribeirão Preto, University of São Paulo. lafajunior@netsite.com.br
Rodrigues
Alfredo José
AJ
Evora
Paulo Roberto Barbosa
PR
Basseto
Solange
S
Scorzoni Filho
Adilson
A
Luciano
Paula Menezes
PM
Pinheiro
Karina Simonelly
KS
Vicente
Walter Villela Andrade
WV
D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D005112:Extracorporeal Circulation; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality* / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000401:mortality* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012307:Risk Factors; D013997:Time Factors