OBJECTIVE: To identify independent factors associated with early (30-day) mortality and in surviving patients, identify factors for late (1-year) mortality following primary coronary artery bypass graft (CABG) surgery and to test the interaction with age. METHODS: An analysis of a single centre's data contribution to the Society for Cardiothoracic Surgery in Great Britain and Ireland database was performed. Data on consecutive patients aged > or =75 years (n=659) and aged 60-74 years (n=3024) undergoing primary CABG surgery (1999-2005) were analysed. One-year mortality data were collected using the Office of National Statistics (ONS) tracking system. Factors associated with early and late mortality were identified using Cox regression; hazard ratios (HRs) and 95% confidence intervals (CIs) are presented. RESULTS: The proportion of patients aged > or =75 years increased by 10% over 5 years (2000-2005). One-year mortality in the elderly showed a significant linear decrease from 15% to 7% (p=0.01) while mortality in the younger cohort remained static at 2-4%. Early mortality in the elderly group was 5% compared to 1.8% in the younger group (p<0.001), while late mortality was 4.1% vs 1.8%, respectively (p<0.001). Factors independently associated with early mortality were age > or =75 years, HR 2.0 (95% CI 1.28, 3.11); female gender; angina (CSS III-IV); and cardiopulmonary bypass duration >97 minutes. Arrhythmia and renal impairment were risk factors common in both early and late mortality models. Risk factors for late mortality also included ventricular ejection fraction <30%, non-elective surgery and arteriopathy. Age was not an independent risk factor for late mortality. CONCLUSION: Mortality in elderly patients showed a substantial improvement, but remained over twice that of younger patients. The difference in factors associated with early and 1-year morality suggests the need for effective short- and long-term strategies, particularly in the management of chronic diseases such as heart and renal failure.
OBJECTIVE: To identify independent factors associated with early (30-day) mortality and in surviving patients, identify factors for late (1-year) mortality following primary coronary artery bypass graft (CABG) surgery and to test the interaction with age. METHODS: An analysis of a single centre's data contribution to the Society for Cardiothoracic Surgery in Great Britain and Ireland database was performed. Data on consecutive patients aged > or =75 years (n=659) and aged 60-74 years (n=3024) undergoing primary CABG surgery (1999-2005) were analysed. One-year mortality data were collected using the Office of National Statistics (ONS) tracking system. Factors associated with early and late mortality were identified using Cox regression; hazard ratios (HRs) and 95% confidence intervals (CIs) are presented. RESULTS: The proportion of patients aged > or =75 years increased by 10% over 5 years (2000-2005). One-year mortality in the elderly showed a significant linear decrease from 15% to 7% (p=0.01) while mortality in the younger cohort remained static at 2-4%. Early mortality in the elderly group was 5% compared to 1.8% in the younger group (p<0.001), while late mortality was 4.1% vs 1.8%, respectively (p<0.001). Factors independently associated with early mortality were age > or =75 years, HR 2.0 (95% CI 1.28, 3.11); female gender; angina (CSS III-IV); and cardiopulmonary bypass duration >97 minutes. Arrhythmia and renal impairment were risk factors common in both early and late mortality models. Risk factors for late mortality also included ventricular ejection fraction <30%, non-elective surgery and arteriopathy. Age was not an independent risk factor for late mortality. CONCLUSION: Mortality in elderly patients showed a substantial improvement, but remained over twice that of younger patients. The difference in factors associated with early and 1-year morality suggests the need for effective short- and long-term strategies, particularly in the management of chronic diseases such as heart and renal failure.
Authors: Carlos Alberto Dos Santos; Marcos Aurélio Barboza de Oliveira; Antônio Carlos Brandi; Paulo Henrique Husseini Botelho; Josélia de Cássia Menin Brandi; Marcio Antônio Dos Santos; Moacir Fernandes de Godoy; Domingo Marcolino Braile Journal: Rev Bras Cir Cardiovasc Date: 2014 Oct-Dec
Authors: Marcos Aurélio Barboza de Oliveira; Carlos Alberto Dos Santos; Antônio Carlos Brandi; Ana Helena Dotta; Paulo Henrique Husseini Botelho; Moacir Fernandes de Godoy; Domingo M Braile Journal: Braz J Cardiovasc Surg Date: 2019 Mar-Apr
Authors: Giovanni Filardo; Baron L Hamman; Benjamin D Pollock; Briget da Graca; Danielle M Sass; Teresa K Phan; James Edgerton; Syma L Prince; W Steves Ring Journal: Open Heart Date: 2016-03-22