Morbimortality in octogenarian patients submitted to coronary artery bypass graft surgery.
BACKGROUND
Given the progressive increase in longevity and the need of an increasingly elderly population to undergo myocardial revascularization surgery (MRS), it becomes necessary to know its risks and benefits.


OBJECTIVE
To evaluate the in-hospital morbimortality of patients aged 80 and older submitted to MRS and identify its predictor variables.


METHODS
A total of 140 consecutive cases were studied between January 2002 and December 2007. The patients' mean age was 82.5 +/- 2.2 years (range: 80-89) and 55.7% were males. In the sample,72.9% had arterial hypertension, 26.4% had diabetes, 65.7% presented severe lesion in three or more vessels and 28.6% presented a severe lesion in the left coronary trunk. An associated surgery was present in 35.7% of the cases, with aortic valve in 26.4% and mitral valve in 5.6%.


RESULTS
The mortality rate was 14.3% (isolated MRS 10.0% vs 22.0% with associated procedure; p = 0.091) and the morbidity was 37.9% (isolated MRS 34.4% vs 44.0% with associated procedure; p = 0.35). The most frequent complications were low cardiac output (27.9%), renal dysfunction (10.0%) and prolonged ventilatory support (9.6%). At the bivariate analysis, the most important mortality predictors were sepsis (RR 10.2; 95%CI: 6.10-17.7), previous MRS (RR 8.06; 95%CI: 5.16-12.6), postoperative low cardiac output (RR 7.77; 95%CI: 3.03-19.9) and postoperative renal dysfunction (RR 7.36; 95%CI: 3.71-14.6). The morbidity predictors were extracorporeal circulation time > 120 min. (RR: 2.34; 95%CI: 1.62-3.38) and time of ischemia > 90 min. (RR: 2.29 95%CI: 1.56-3.37).


CONCLUSIONS
The MRS in octogenarians is associated with a higher morbimortality when compared to younger patients, which, however, does not prevent the procedure if the indication is justified by clinical condition.
Pivatto Júnior
Fernando
F
Instituto de Cardiologia do Rio Grande do Sul/FUC.
Kalil
Renato A K
RA
Costa
Altamiro R
AR
Pereira
Edemar M C
EM
Santos
Eduardo Z
EZ
Valle
Felipe H
FH
Bender
Luciano P
LP
Trombka
Marcelo
M
Modkovski
Thaís B
TB
Nesralla
Ivo A
IA
D000367:Age Factors; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality* / Q000601:surgery; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors