Long term results and functional outcomes following cardiac surgery in octogenarians.
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.
Nwaejike
Nnamdi
N
Department of Vascular and Endovascular Surgery, The Royal London Hospital, Barts and the London NHS Trust, London, UK.
Breen
Niall
N
Bonde
Pramod
P
Campalani
Gianfranco
G
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