title: Urgent aortic valve replacement in octogenarians: does an 'urgent' status increase morbidity and mortality?
abstract: OBJECTIVE
  The study aim was to investigate the influence of 'urgent' status on short and long-term mortality and morbidity in a consecutive series of octogenarian patients who underwent aortic valve replacement (AVR).
  
  
  METHODS
  Between January 2005 and March 2009, data were extracted for 141 consecutive patients aged over 80 years who underwent AVR either urgently (n = 49) or electively (n = 92). Early outcomes (in-hospital mortality, postoperative morbidities) and long-term outcomes were compared during a 39-month follow up period. The outcomes were compared after adjustment for differences in baseline risk factors.
  
  
  RESULTS
  Patients of the 'urgent' group were older and had more comorbidities than those in the 'elective' group. There was a non-significant trend towards a higher in-hospital mortality in the 'urgent' group (10.2% versus 4.3%, p = 0.18). The 39-month survival rate was 81% in elective patients, and 71% in urgent patients (p = 0.166).
  
  
  CONCLUSIONS
  AVR can be performed in the elderly population with acceptable early and mid-term results, despite their urgent status. A large clinical trial is warranted to confirm the influence of an urgent status in octogenarian patients treated with surgical AVR.
authors.affiliation: Cardiovascular Surgery Department of Qilu Hospital of Shandong University, Jinan, China. xycyang@hotmail.com
authors.forename: Changyong
authors.initials: C
authors.lastname: Yang
authors.forename: Dadong
authors.initials: D
authors.lastname: Li
authors.forename: Roger
authors.initials: R
authors.lastname: Mennett
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hammond
authors.forename: Gong
authors.initials: G
authors.lastname: Zhang
authors.forename: Donghui
authors.initials: D
authors.lastname: Chen
authors.forename: Robert
authors.initials: R
authors.lastname: Gallagher
mesh_terms: D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000401:mortality* / Q000601:surgery*; D016208:Databases, Factual / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009017:Morbidity