title: Outcome after valve surgery in octogenarians and efficacy of early mobilization with early cardiac rehabilitation.
abstract: OBJECTIVE
  This study aimed to compare postoperative complications and the surgical outcome in patients aged <80 years versus octogenarian patients. Another aim was to evaluate the safety and efficacy of early mobilization with early cardiac rehabilitation in octogenarians.
  
  
  METHODS
  A retrospective analysis was performed in 138 consecutive patients (group Y comprised 118 patients <80 years, and group O comprised 20 octogenarians) who had undergone valve surgery at the authors' institution between July 2007 and December 2009. Furthermore, the efficacy of early mobilization with early cardiac rehabilitation and long-term results were analyzed in 40 consecutive octogenarian patients undergoing valve surgery from 2000. The late survival follow-up was 100% complete.
  
  
  RESULTS
  Redo cardiac operations were more frequent (O group 15.0% vs. Y group 3.4%, P = 0.011), and the preoperative EuroSCORE was significantly higher in group O than in group Y (group O 16.4 ± 18.3 vs. group Y 7.5 ± 9.1, P = 0.001). The incidence of delirium/confusion and worsening of renal function after surgery was higher in group O. The hospital mortality was 1.7% in group Y and no hospital death in group O (P > 0.99). Early mobilization with early cardiac rehabilitation significantly reduced the incidence of postoperative delirium/confusion and increased the number of patients who could return directly home. The actuarial 5-year survival rate was 77.7% for octogenarians.
  
  
  CONCLUSIONS
  Although there were more high-risk patients among the octogenarians, valve surgery was a safe, low-risk procedure with excellent long-term results. Early mobilization with early cardiac rehabilitation was significantly effective and safe for postoperative recovery in octogenarians after cardiac valve surgery.
authors.affiliation: Department of Cardiovascular Surgery, Miyazaki Prefectural Nobeoka Hospital, 2-1-1 Shin-Koji, Nobeoka, Miyazaki, 882-0835, Japan. shiori@med.miyazaki-u.ac.jp
authors.forename: Kunihide
authors.initials: K
authors.lastname: Nakamura
authors.forename: Eisaku
authors.initials: E
authors.lastname: Nakamura
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Niina
authors.forename: Kazushi
authors.initials: K
authors.lastname: Kojima
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects; D004434:Early Ambulation; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000401:mortality / Q000534:rehabilitation; D017052:Hospital Mortality; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome