title: Impact of severe postoperative complications after cardiac surgery on mortality in patients aged over 80 years.
abstract: BACKGROUND
  The aims of this study are (1) to investigate the occurrence rate of postoperative complications in patients ≥ 80 years old after cardiac surgery and (2) to elucidate the impact of the most common postoperative complications on mortality.
  
  
  METHODS
  Between January 1998 and December 2007, 649 patients aged over 80 years received isolated first-time coronary artery bypass graft (CABG), isolated aortic valve replacement (AVR) or a combination of both in our institute. Prospectively entered patient data were analyzed with respect to major complications and outcome parameters.
  
  
  RESULTS
  Acute renal failure (55.0% vs. 7.5%, p = 0.0001), low cardiac out-put syndrome (43.1% vs. 8.8%, p = 0.0001), sepsis (52.0% vs. 10.3%, p = 0.0001), prolonged respiratory failure with tracheotomy (29.0% vs. 11.0%, p = 0.002), re-thoracotomy due to bleeding (26.9% vs. 10.6%, p = 0.0001), and postoperative laparotomy (30.8% vs. 11.5%, p = 0.033) had a significant impact on mortality. A multivariate analysis revealed that advanced age (OR 1.130, 95%CI; 1.017-1.256, p = 0.023), low output syndrome (OR 5.094, 95%CI; 1.1635-15.871, p = 0.005), renal failure (OR 8.128, 95%CI; 3.347-19.742, p = 0.0001) and sepsis (OR 4.975, 95%CI; 1.420-17.426, p = 0.012) as independent risk factors.
  
  
  CONCLUSIONS
  The present study demonstrates that among major complications, low output syndrome, renal failure requiring renal replacement therapy and sepsis, dramatically impaired the postoperative course patients aged over 80 years undergoing CABG, AVR or combined CABG and AVR.
authors.affiliation: Department of Cardiovascular Surgery, Duesseldorf University Hospital, Duesseldorf, Germany.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kamiya
authors.forename: Nadine
authors.initials: N
authors.lastname: Tanzeem
authors.forename: Payam
authors.initials: P
authors.lastname: Akhyari
authors.forename: Anabel
authors.initials: A
authors.lastname: Pedraza
authors.forename: Klaus
authors.initials: K
authors.lastname: Kallenbach
authors.forename: Artur
authors.initials: A
authors.lastname: Lichtenberg
authors.forename: Matthias
authors.initials: M
authors.lastname: Karck
mesh_terms: D058186:Acute Kidney Injury / Q000401:mortality / Q000628:therapy; D000367:Age Factors; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D002303:Cardiac Output, Low / Q000401:mortality / Q000628:therapy; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality*; D005260:Female; D005858:Germany; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000401:mortality* / Q000628:therapy; D006435:Renal Dialysis; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000401:mortality / Q000628:therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome