Impact of Age on the Results of Coronary Artery Bypass Grafting

Abstract

As the average age of patients undergoing cardiac surgery is increasing, the effects of age on the incidence of postoperative complications and 30-day mortality after coronary artery bypass grafting were examined. The EuroSCORE and corresponding age-stripped EuroSCORE were calculated in 6,057 patients who underwent isolated coronary bypass between January 1996 and January 2002. Both EuroSCORE and age-stripped EuroSCORE exhibited a significant increase with age in the whole group of patients and in those who were alive 30 days after surgery. The 30-day mortality and the incidence of postoperative complications increased significantly with age. A significant age-dependent increase in EuroSCORE was found in patients who died within 30 days postoperatively, whereas no age dependence was observed in the age-stripped EuroSCORE. Univariate analysis showed diabetes mellitus and atrial fibrillation to be significant risk factors for 30-day mortality; atrial fibrillation was also found to significantly affect 30-day mortality on multivariate analysis. In view of the increasing co-morbidity and age-dependent organ changes in the elderly, specific preventive and therapeutic measures are needed in this group of patients undergoing cardiac surgery.

Secondary Prevention After Coronary Artery Bypass Graft Surgery

“…Early after surgery, smokers have an increased rate of atelectasis and pneumonia and an increased requirement for mechanical ventilation and intensive care support. 290,291 In addition to an increased risk of pulmonary complications, smoking is associated with an increased risk of deep sternal wound infections in adults who undergo cardiac surgery. 292 Smokers have a higher prevalence of myocardial ischemia 293 and require repeat coronary revascularization procedures more frequently.…”

Coronary artery bypass surgery in elderly people

“…In an analysis of 6057 patients who underwent isolated CABG between 1996 and 2002, the 30-day mortality rate and the incidence of postoperative complications was found to largely escalate with age. 27 In-hospital outcomes and cost were examined among 2272 elderly people (>75 years) and 9745 younger patients (,75 years) who underwent CABG between 1997 and 2001 in another study. 29 After controlling for clinical differences, age >75 years was found to be associated with a longer length of hospital stay, higher mortality rates and higher in-hospital cost.…”

EuroSCORE e os pacientes submetidos a revascularização do miocárdio na Santa Casa de São Paulo

“…Additionally, with the aging of the population, a considerable number of elderly patients are referred for surgical treatment [1][2][3]. Thus, this therapeutic option has been offered to an increasing number of the most varied patients.…”