Is an age of 80 years or greater an important predictor of short-term outcomes of isolated aortic valve replacement in veterans?
BACKGROUND
There is a popular perception that aortic valve replacement (AVR) in octogenarians carries a high risk related primarily to advanced age.


METHODS
Using the Department of Veterans Affairs Continuous Improvement in Cardiac Surgery Program, we identified patients who underwent AVR between 1991 and 2007. A prediction model was constructed using stepwise logistic regression methodology for outcome comparisons.


RESULTS
Compared with younger patients (age < 80 years; n = 6,638), older patients (age > or = 80; n = 504) had a higher prevalence of baseline comorbidities. In a comparison of patients propensity-matched by risk profile (459 from each group), the older group had a higher morbidity rate (21.1% vs 15.5%; p < 0.03) but a similar mortality rate (5.2% vs 3.3%; p = 0.19) compared with the younger group.


CONCLUSIONS
After risk adjustment, age of 80 years or greater was independently associated with higher AVR-related morbidity but not mortality. Further work is needed to identify ways to reduce operative morbidity in the extremely elderly.
Bakaeen
Faisal G
FG
Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA. fbakaeen@bcm.edu
Chu
Danny
D
Huh
Joseph
J
Carabello
Blase A
BA
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome