Are octogenarians in good condition after cardiac valvular surgery?
OBJECTIVE
With the aging of society in developed countries and advances in surgical technology in recent years, surgery is increasing in elderly patients. When performing surgery in older patients, both surgical outcomes and the maintenance of postoperative quality of life (QOL) are important issues. This study investigated surgical outcomes and postoperative QOL in octogenarians who underwent cardiac valvular surgery.


RESULTS
Fifty-nine (16 males) octogenarians (80-89 years old, mean age, 82.4 ± 2.4 years) underwent cardiac valvular surgery between August 1999 and June 2011. A QOL questionnaire, which included the Barthel Index (BI), Fillenbaum Instrumental Activities of Daily Living (FIADL), and the Vitality Index (VI), was sent to all survivors. Kaplan-Meier analysis was used to assess survival. Hospital mortality was 1.6% (1 patient). The 3-, 5-, and 7-year survival rates were 81.2%, 75.4%, and 67.8%, respectively. The BI showed that 87.5% of patients did not require caregiving, the FIADL showed that 32.5% were highly independent, and the VI showed that 87.5% were motivated to live.


CONCLUSIONS
Short-term outcomes were satisfactory, with low complication and mortality rates. Mid-term outcomes showed maintenance of the minimal required ADL and good motivation for living. However, independence in social activities was decreased, suggesting the need for comprehensive social support.
Department of Cardiovascular Surgery, Nagasaki University Graduate School of Medicine, Nagasaki, Nagasaki, Japan.
Mizuki
M
Sumi
Tsuneo
T
Ariyoshi
Takashi
T
Miura
Wataru
W
Hashimoto
Koji
K
Hashizume
Seiji
S
Matsukuma
Kiyoyuki
K
Eishi
D000203:Activities of Daily Living; D000367:Age Factors; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D015577:Geriatric Assessment; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D006351:Heart Valves / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D057187:Independent Living; D053208:Kaplan-Meier Estimate; D008297:Male; D009042:Motivation; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000401:mortality / Q000523:psychology; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D012919:Social Behavior; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome