title: Long term results and functional outcomes following cardiac surgery in octogenarians.
abstract: OBJECTIVE
  Cardiac surgery for patients >80 years has seen a dramatic increase in the last decade. The aim was to assess the long term survival and quality of life in this patient population.
  
  
  METHODS
  Patients who underwent cardiac surgery between 1995 and 2007 were identified and case notes reviewed. Follow-up was undertaken by personal interview with the patient or the nearest kin to complete a pre-planned questionnaire.
  
  
  RESULTS
  Sixty six (M:F; 45:21) octogenarians had Coronary artery bypass grafting (CABG) only (55%), Aortic valve replacement (AVR) only (12%), Mitral valve replacement (MVR) only (3%), Valve and CABG (25%) and complex procedures (5%). Fifty-eight percent were elective procedures. Operative mortality was 8% (n = 5). Multivariate analysis identified complex procedures, prolonged bypass time and re-do/emergency surgery as predictors of death (p < 0.05). Median Intensive care unit (ICU) stay was 206 h (range 43-1176 h), with >70% leaving ICU in 72 h. Late mortality involved five patients (8%) who died at 10 yr; 7 yr; 3 yr; 1 yr; and 8 months; and 2 yr and 7 months, respectively. Survival by Kaplan-Meir was 8.8 yr (Standard Error (SE) = 0.66, Confidence interval (CI) 7.6-10.1), median survival was 10 yr and mean Barthel's index 17.7 (min 0, max 20).
  
  
  CONCLUSIONS
  Cardiac surgery can be accomplished in octogenarians with good long-term survival and quality of life. However, complex procedures, prolonged bypass and re-do/emergency surgery contribute significantly to mortality.
authors: Department of Vascular and Endovascular Surgery, The Royal London Hospital, Barts and the London NHS Trust, London, UK.
authors: Nnamdi
authors: N
authors: Nwaejike
authors: Niall
authors: N
authors: Breen
authors: Pramod
authors: P
authors: Bonde
authors: Gianfranco
authors: G
authors: Campalani
mesh_terms: D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008485:Medical Audit; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012189:Retrospective Studies; D016019:Survival Analysis