STUDY OBJECTIVES: To evaluate cost, outcome, and functional status of octogenarians and septuagenarians after cardiac surgery. DESIGN: Observational case control study. Retrospective analysis of hospital cost and outcome. Prospective analysis of functional status at 1 to 2 years. PATIENTS: One hundred three consecutive octogenarians and 103 randomly selected septuagenarians who underwent cardiac surgery. SETTING: A university-affiliated tertiary care center. MEASUREMENTS AND RESULTS: Compared to septuagenarians, octogenarians were more likely to be widowed (p < or = 0.001) and to have had preoperative strokes (p < or = 0.05) but were less likely to have diabetes mellitus (p < or = 0.001). They were less likely to have undergone mitral valve surgery (p < or = 0.01) but were more likely to have undergone coronary artery bypass graft surgery without cardiopulmonary bypass (p < or = 0.001). The hospital mortality rate was 6% in the younger group and 9% in the older group (odds ratio, 1.5; 95% confidence interval [CI], 0.5 to 4.5; p > 0.05). In patients undergoing isolated CABG, the mortality rate was 1.4% in the septuagenarians and 8.2% in the octogenarians (odds ratio, 6.2; 95% CI, 0.7 to 52.7; p = 0.12). Despite similar ICU, postoperative, and total lengths of stay, the median hospital direct variable cost was 35% higher for the octogenarians. At late follow-up, octogenarians had lower levels of physical functioning and general health but otherwise had levels of function that were similar to those of septuagenarians. CONCLUSION: Cardiac surgery can be performed in the elderly with good hospital and late functional results, but at a higher hospital cost than that for younger patients.
STUDY OBJECTIVES: To evaluate cost, outcome, and functional status of octogenarians and septuagenarians after cardiac surgery. DESIGN: Observational case control study. Retrospective analysis of hospital cost and outcome. Prospective analysis of functional status at 1 to 2 years. PATIENTS: One hundred three consecutive octogenarians and 103 randomly selected septuagenarians who underwent cardiac surgery. SETTING: A university-affiliated tertiary care center. MEASUREMENTS AND RESULTS: Compared to septuagenarians, octogenarians were more likely to be widowed (p < or = 0.001) and to have had preoperative strokes (p < or = 0.05) but were less likely to have diabetes mellitus (p < or = 0.001). They were less likely to have undergone mitral valve surgery (p < or = 0.01) but were more likely to have undergone coronary artery bypass graft surgery without cardiopulmonary bypass (p < or = 0.001). The hospital mortality rate was 6% in the younger group and 9% in the older group (odds ratio, 1.5; 95% confidence interval [CI], 0.5 to 4.5; p > 0.05). In patients undergoing isolated CABG, the mortality rate was 1.4% in the septuagenarians and 8.2% in the octogenarians (odds ratio, 6.2; 95% CI, 0.7 to 52.7; p = 0.12). Despite similar ICU, postoperative, and total lengths of stay, the median hospital direct variable cost was 35% higher for the octogenarians. At late follow-up, octogenarians had lower levels of physical functioning and general health but otherwise had levels of function that were similar to those of septuagenarians. CONCLUSION: Cardiac surgery can be performed in the elderly with good hospital and late functional results, but at a higher hospital cost than that for younger patients.
Authors: S C Stoica; F Cafferty; J Kitcat; R J F Baskett; M Goddard; L D Sharples; F C Wells; S A M Nashef Journal: Heart Date: 2005-08-23 Impact factor: 5.994
Authors: A D Nagpal; G Bhatnagar; C A Cutrara; S M Ahmed; N McKenzie; M Quantz; B Kiaii; A Menkis; S Fox; L Stitt; R J Novick Journal: Can J Cardiol Date: 2006-08 Impact factor: 5.223
Authors: Damien J LaPar; Zequan Yang; George J Stukenborg; Benjamin B Peeler; John A Kern; Irving L Kron; Gorav Ailawadi Journal: J Thorac Cardiovasc Surg Date: 2009-12-16 Impact factor: 5.209