Does Gender Affect Outcome of Cardiac Surgery in Octogenarians?

Abstract

The long-term results of cardiac surgery in 212 consecutive octogenarians (116 men, 96 women) were reviewed retrospectively. Preoperative functional status, Euroscore, and the incidences of hypertension and chronic obstructive pulmonary disease were similar in both sexes. Women had more diabetes mellitus (45% versus 25%; p < 0.05) but less renal dysfunction (16% versus 29%; p < 0.05). Men required emergency procedures more frequently (p < 0.05). Women underwent complete revascularization more often and had more arterial grafts. Hospital mortality was similar (11.5% in women versus 12.9% in men), but women had more complications (76% versus 64%), longer convalescence (24.3 versus 18.5 days), fewer psychiatric disorders (14% versus 23%) and less heart block (9% versus 19%). Men had a slightly better outcome in terms of functional class and Euroqol score during follow-up of up to 114 months. Median survival was longer in women (3.15 versus 2.96 years) but 1-, 3-, and 5-year survival rates and late deaths were similar. Outcomes appear to be equitable for both sexes among octogenarians.

EQ-5D in Central and Eastern Europe: 2000–2015

“…Two of them were large European multi-country studies that involved more than one CEE country [45,46]. Overall 152 reports on country level results were obtained: Austria (n=11) [47][48][49][50][51][52][53][54][55][56][57], Bulgaria (n=6) [45,46,58,59,13], Czech Republic (n=18) [60,61,45,46,[62][63][64][65][66]20,[67][68][69][70][71][72][73][74], Hungary (n=47) [11,75,76,45,[77][78][79][80][81][82][83][84][85][86]…”

“…In one study, the EQ VAS scale was modified to range from 0 to 10 [173]. Alternative scoring techniques occurred in some studies; for example, the ordinal numeric labels for the health state levels in the instrument (1-3 or 1-5) were treated as cardinal values that can be summed [51,90,95,163,54,116,126,131,65,171,173], which is a flawed concept because these numbers have no intrinsic arithmetic properties. Another study expressed the EQ-5D index score as a percentage [72], which can be misleading when considering the possible negative values.…”

“…The majority of the studies had a cross-sectional design (n=85; 59%). For longitudinal studies (n=55; 38%), the length of follow-up ranged from 10 days [171] to 9.5 years [51]. Registrybased studies (n=3) were identified only in the Czech Republic and Hungary [77,64,74].…”

Does quality of life improve in octogenarians following cardiac surgery? A systematic review

“… 25–33 One study found lower scores in the physical domains of the study population. 34 Two studies reported poorer outcomes in women, 35 36 however a third paper revealed the opposite. 29 Three studies compared postoperative QoL in octogenarians against a younger patient cohort.…”