title: The role of age and comorbidities in postoperative outcome of mitral valve repair: A propensity-matched study.
abstract: The average age of patients undergoing mitral valve repair is increasing each year. This retrospective study aimed to compare postoperative complications of mitral valve repair (known to be especially high-risk) between 2 age groups: under and over the age of 80.Patients who underwent mitral valve repair were divided into 2 groups: group 1 (<80 years old) and group 2 (≥80 years old). Baseline characteristics, pre- and postoperative hemodynamic data, surgical characteristics, and postoperative follow-up data until hospital discharge were collected.A total of 308 patients were included: 264 in group 1 (age 63 ± 13 years) and 44 in group 2 (age 83 ± 2 years). Older patients had more comorbidities (atrial fibrillation, history of cardiac decompensation, systemic hypertension, pulmonary hypertension, and chronic kidney disease) and they presented more postoperative complications (50.0% vs 33.7%; P = 0.043), with a longer hospital stay (8.9 ± 6.9 vs 6.6 ± 4.6 days; P = 0.005). To assess the burden of age, a propensity score was awarded to postoperative complications. Active smoking, chronic pulmonary disease, chronic kidney disease, associated ischemic heart disease, obesity, and cardio pulmonary by-pass duration were described as independent risk factors. When matched on this propensity score, there was no difference in morbidity or mortality between group 1 and group 2.Older patients suffered more postoperative complications, which were related to their comorbidities and not only to their age.
authors.affiliation: Pôle Réanimations Anesthésie SAMU/SMUR, CHU de Caen, Avenue de la Côte de Nacre Department of Cardiac Surgery Department of Cardiology, University Hospital of Caen, Caen Department of Anaesthesiology and Critical Care, Hôpital Cardiologique Louis Pradel, Avenue du Doyen Lepine Faculty of Medicine, University of Lyon 1 Claude Bernard, Lyon EA 4650, Université de Caen Basse-Normandie, Esplanade de la Paix, CS, Caen, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Bonnet
authors.forename: Clément
authors.initials: C
authors.lastname: Boisselier
authors.forename: Vladimir
authors.initials: V
authors.lastname: Saplacan
authors.forename: Annette
authors.initials: A
authors.lastname: Belin
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Gérard
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Fellahi
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Hanouz
authors.forename: Marc-Olivier
authors.initials: MO
authors.lastname: Fischer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D015994:Incidence; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000453:epidemiology* / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology*; D057216:Propensity Score; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome