Is urgent coronary artery bypass grafting a safe option in octogenarians? A developing country perspective.
Life expectancy has increased during recent decades leading to a growing number of older population. The objective of this study was to evaluate the outcomes of coronary artery bypass grafting (CABG) in octogenarians and to compare the outcomes of the emergent CABG with elective surgery. Prospectively collected data from 31 consecutive octogenarian patients who underwent CABG between 1 January 2006 and 31 December 2008 were analyzed. Main outcomes of interest included mortality, length of ICU stay, length of hospital stay, priority of surgery, postoperative complications and functional status on follow-up. Fifteen patients were operated on an urgent basis. Patients operated on an urgent basis were in NYHA class III or IV preoperatively (P=0.0016). There were no significant differences in operative and postoperative variables. There were three in-hospital deaths and 23 patients (82%) were alive on follow-up and 19 were in functional class I or II. Quality of life assessment was performed using Seattle Angina Questionnaire and patients reported remarkable improvement in quality of life. Overall, 90% patients were not or slightly disabled in their daily activity. Satisfaction with their current quality of life was reported by 95% of patients. CABG may be performed in octogenarians with remarkable outcomes and improvement in quality of life.
Luqman
Zubair
Z
Department of Surgery, The Aga Khan University Hospital, Karachi 74800, Pakistan. zubair.luqman@aku.edu
Ansari
Junaid
J
Siddiqui
Fahad Javaid
FJ
Sami
Shahid Ahmed
SA
D000203:Activities of Daily Living; D000367:Age Factors; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D003422:Critical Care; D003906:Developing Countries / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures; D004638:Emergency Treatment; D005260:Female; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D010154:Pakistan; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome