Predictors of postoperative complications in high-risk octogenarians undergoing cardiac operations

Gatti, Giuseppe; Cardu, Gabriele; Lusa, Anna Maria; Pugliese, Peppino

doi:10.1016/s0003-4975(02)03741-4

Cited by 35 publications

(12 citation statements)

References 17 publications

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“…In octogenarians, the overall 3-year survival rate was 73±8%, which is comparable with or higher than other similar studies. 1,3,9,17,18 Urgent operation in octogenarians has been a predictor of early and late mortality in the recent studies, and those authors recommend that early referral of patients before severe cardiac dysfunction is mandatory to improve early and late survival; 4,8,[16][17][18][19][20] however, we found no significant differences in late survival with urgent surgical priority (Fig 5). The predictors of late death in the present octogenarians were male gender and a high EuroSCORE score.…”

Section: Discussionmentioning

confidence: 57%

Early and Late Results of Cardiac and Thoracic Aortic Surgery in Octogenarians-Comparison With High-Risk Younger Patients-

Kawachi

Nakashima

Kosuga

et al. 2003

Circ J

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Forty octogenarians (OCTO) undergoing a variety of cardiac and thoracic aortic surgeries using cardiopulmonary bypass (CPB) between 1994 and 2002 were retrospectively studied. The results were compared with those of high-risk younger patients aged less than 60 years (YOUNG) (n=89). All patients had an expected operative mortality of EuroSCORE 5 and over. The EuroSCORE score was 9.9+/-3.3 (range, 5-18) in the OCTO group and 6.8+/-2.3 (range, 5-16) in the YOUNG patients (p<0.0001). There were 4 (10%) and 10 (11%) hospital deaths, respectively (p>0.99). Major postoperative complications occurred in 50% of the OCTO and 36% of the YOUNG patients (p=0.17). There were 10 and 7 late deaths, respectively. Actuarial survival including hospital death was significantly lower in the OCTO group than in the YOUNG (p=0.033). Actuarial survival was significantly higher in female octogenarians than in male (p=0.046). The overall 3-year survival rate was 88+/-8% and 64+/-11%, respectively. Multivariate analysis showed that predictors of late death were male gender (p=0.0005) and a high EuroSCORE (p=0.0010). Cardiac and thoracic aortic surgery using CPB can be performed in octogenarians with an acceptable hospital mortality rate and gratifying medium-term survival results.

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Section: Discussionmentioning

confidence: 57%

Early and Late Results of Cardiac and Thoracic Aortic Surgery in Octogenarians-Comparison With High-Risk Younger Patients-

Kawachi

Nakashima

Kosuga

et al. 2003

Circ J

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Section: Resultsmentioning

confidence: 99%

“…Implantable cardiovascular devices, that is, signal prostheses and conduction prostheses that can be deployed percutaneously, represent a most extraordinary revolution in the treatment of cardiovascular illnesses. 58,59 According to Dhrura, in 2008 at least 350,000 pacemakers, 140,000 cardioverterdefibrillators, and 1,230,000 stents were implanted in the United States. 60 Half a century has elapsed since the first pacemaker implantation, paving the way for sophisticated devices which can provide electrical pulse transmission that support the mechanical function of the heart.…”

Section: Resultsmentioning

confidence: 99%

The marvel of percutaneous cardiovascular devices in the elderly

Guidoin

Douville

Clavel

et al. 2010

Annals of the New York Academy of Sciences

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Thanks to minimally invasive procedures, frail and elderly patients can also benefit from innovative technologies. More than 14 million implanted pacemakers deliver impulses to the heart muscle to regulate the heart rate (treating bradycardias and blocks). The first human implantation of defibrillators was performed in early 2000. The defibrillator detects cardiac arrhythmias and corrects them by delivering electric shocks. The ongoing development of minimally invasive technologies has also broadened the scope of treatment for elderly patients with vascular stenosis and aneurysmal disease as well as other complex vascular pathologies. The nonsurgical cardiac valve replacement represents one of the most recent and exciting developments, demonstrating the feasibility of replacing a heart valve by way of placement through an intra-arterial or trans-ventricular sheath. Percutaneous devices are particularly well suited for the elderly as the surgical risks of minimally invasive surgery are considerably less as compared to open surgery, leading to a shorter hospital stay, a faster recovery, and improved quality of life.

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“…Commonly observed POPCs are atelectasis, pneumonia and hypoxic respiratory failure. According to data published by Fisher et al [1] and by Gatti et al [2] the incidence of pulmonary complications postoperatively is in the range of 2-39 %. Upper abdominal surgeries, thoracic surgeries, lower abdominal surgeries are responsible for these situations.…”

Section: Review Of Literaturementioning

confidence: 97%

Protocol of an observational, follow up, single arm study for knowing the compliance of patients scheduled for major abdominal and thoracic surgeries who were instructed to perform spirome

2017

Med One

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Predictors of postoperative complications in high-risk octogenarians undergoing cardiac operations

Cited by 35 publications

References 17 publications

Early and Late Results of Cardiac and Thoracic Aortic Surgery in Octogenarians-Comparison With High-Risk Younger Patients-

Early and Late Results of Cardiac and Thoracic Aortic Surgery in Octogenarians-Comparison With High-Risk Younger Patients-

The marvel of percutaneous cardiovascular devices in the elderly

Protocol of an observational, follow up, single arm study for knowing the compliance of patients scheduled for major abdominal and thoracic surgeries who were instructed to perform spirome

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