Cost, Outcome, and Functional Status in Octogenarians and Septuagenarians after Cardiac Surgery

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

“…298,1126 Retrospective studies have observed a substantially higher in-hospital mortality rate among octogenarians than among younger patients. [1127][1128][1129][1130] A report from the National Cardiovascular Network of outcomes in 67 764 patients undergoing cardiac surgery, of whom 4743 were octogenarians, showed that the in-hospital mortality rate for the octogenarians was substantially higher (3.0% versus 8.1%; PϽ0.001). 1127 Several retrospective studies of patients undergoing CABG have reported a higher incidence of neurological complications, renal failure, respiratory failure, and gastrointestinal complications among octogenarians than among younger subjects.…”

“…1127 Several retrospective studies of patients undergoing CABG have reported a higher incidence of neurological complications, renal failure, respiratory failure, and gastrointestinal complications among octogenarians than among younger subjects. 298,1127,1128 In addition, the elderly have longer lengths of stay and are less likely to be discharged home. An analysis of the New York State Department of Health Cardiac Reporting System registry revealed that length of stay after CABG was 8.5 days in patients Ͻ50 years of age and 14.1 days in those Ͼ80 years of age, with discharge-to-home rates of 96% and 52%, respectively.…”

Cardiac Surgery in Elderly Patients: What Is the Evidence?

“…chronic lung disease, peripheral artery disease, diabetes, arterial hypertension, renal failure. This leads to an up to 2 days longer hospital stay in octogenarians compared to younger patients [9]. Survival after CABG in older patients is good [10][11][12][13] (table 2): the outcome corresponds to an ageadjusted population without coronary artery disease, some studies even show an increased survival.…”

Valve surgery in octogenarians: In-hospital and long-term outcomes

“…Although we did not evaluate hospital costs, previous investigators have reported higher costs for older patients than younger patients, and attributed them to longer average periods of hospitalization and more complications (4,7,15). Notwithstanding the higher perioperative morbidity rate and greater costs, the overall operative mortality rate was not prohibitive (9.8%, ranging from 5.2% for isolated aortic valve surgery to 20.4% for MVSc and AVSc) considering the known high risk of such procedures in the very elderly and that late mortality was only 16.2% (ranging from 13.3% for isolated aortic valve surgery to 20.5% for MVSc); furthermore, the functional status of the long-term survivors significantly improved.…”