Isolated coronary artery bypass grafting in extracorporeal circulation in patients over 65 years old - does age still matter?
BACKGROUND
Coronary artery bypass grafting (CABG) is conducted more and more commonly in patients in advanced age.


OBJECTIVE
To analyze the influence of age and concurrent risk factors on the complications and early mortality after CABG.


METHODS
Medical records of 2194 patients were analyzed retrospectively. A group of 1303 patients who had undergone isolated CABG was selected. 106 (4.8%) patients were excluded due to missing data in their medical records. The remaining 1197 patients were divided into two subgroups by age: 1(st) group < 65 years (n = 662; 55.3%); 2(nd) group ≥ 65 years (n = 535; 44.7%).


RESULTS
The total 30-day mortality was 3.93% and was six times higher in the older group (1.21 vs. 7.29%; p < 0.001). Complications were observed in 176 (14.70%) patients, more often in the older group (10.42% vs. 20.0%; p < 0.001). In this group all kinds of complications were noted more often and in particular: postoperative myocardial infarction (1.96% vs. 5.42%; p = 0.001), respiratory dysfunction (1.36% vs. 4.11%; p = 0.005), neurological complications (1.81% vs. 3.74%; p = 0.04) and multi-organ dysfunction syndrome (0.30% vs. 1.68%, p = 0.03). The older patients required longer time under mechanical ventilation (24.0 ± 27.9 vs. 37.0 ± 74.1 hours; p = 0.004) and stayed longer in the intensive care unit: 2.5 ± 3.0 vs. 4.1 ± 7.84 days; p < 0.001. Independent predictors of death were: female sex [OR (95% CI) = 2.4 (1.2-4.5)], age ≥ 65 years [OR = 4.9 (2.1-11.1)], eGFR < 60 mL/min/1.73 m(2) [OR = 2.2 (1.0-4.7)], time at extracorporeal circulation > 72 minutes [OR = 5.5 (2.7-10.9)] and left main stem stenosis (> 50%) [OR = 2.4 (1.3-4.6)].


CONCLUSIONS
Age still significantly influences postoperative complications and mortality after isolated CABG.
Student VI roku Wydziału Lekarskiego Uniwersytetu Medycznego w Łodzi.
Dawid
D
Miśkowiec
Klinika Kardiochirurgii I Katedry Kardiologii i Kardiochirurgii Uniwersytetu Medycznego w Łodzi.
Andrzej
A
Walczak
Klinika Kardiochirurgii I Katedry Kardiologii i Kardiochirurgii Uniwersytetu Medycznego w Łodzi.
Stanisław
S
Ostrowski
Student VI roku Wydziału Lekarskiego Uniwersytetu Medycznego w Łodzi.
Ewa
E
Wrona
Klinika Kardiochirurgii I Katedry Kardiologii i Kardiochirurgii Uniwersytetu Medycznego w Łodzi.
Karol
K
Bartczak
Klinika Kardiochirurgii I Katedry Kardiologii i Kardiochirurgii Uniwersytetu Medycznego w Łodzi.
Ryszard
R
Jaszewski
age; coronary artery bypass grafting