Faisal G Bakaeen1, Danny Chu, Joseph Huh, Blase A Carabello. 1. Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA. fbakaeen@bcm.edu
Abstract
BACKGROUND: There is a popular perception that aortic valve replacement (AVR) in octogenarians carries a high risk related primarily to advanced age. METHODS: Using the Department of Veterans Affairs Continuous Improvement in Cardiac Surgery Program, we identified patients who underwent AVR between 1991 and 2007. A prediction model was constructed using stepwise logistic regression methodology for outcome comparisons. RESULTS: Compared with younger patients (age < 80 years; n = 6,638), older patients (age > or = 80; n = 504) had a higher prevalence of baseline comorbidities. In a comparison of patients propensity-matched by risk profile (459 from each group), the older group had a higher morbidity rate (21.1% vs 15.5%; p < 0.03) but a similar mortality rate (5.2% vs 3.3%; p = 0.19) compared with the younger group. CONCLUSIONS: After risk adjustment, age of 80 years or greater was independently associated with higher AVR-related morbidity but not mortality. Further work is needed to identify ways to reduce operative morbidity in the extremely elderly. 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
BACKGROUND: There is a popular perception that aortic valve replacement (AVR) in octogenarians carries a high risk related primarily to advanced age. METHODS: Using the Department of Veterans Affairs Continuous Improvement in Cardiac Surgery Program, we identified patients who underwent AVR between 1991 and 2007. A prediction model was constructed using stepwise logistic regression methodology for outcome comparisons. RESULTS: Compared with younger patients (age < 80 years; n = 6,638), older patients (age > or = 80; n = 504) had a higher prevalence of baseline comorbidities. In a comparison of patients propensity-matched by risk profile (459 from each group), the older group had a higher morbidity rate (21.1% vs 15.5%; p < 0.03) but a similar mortality rate (5.2% vs 3.3%; p = 0.19) compared with the younger group. CONCLUSIONS: After risk adjustment, age of 80 years or greater was independently associated with higher AVR-related morbidity but not mortality. Further work is needed to identify ways to reduce operative morbidity in the extremely elderly. 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Authors: Norbert Frey; Richard P Steeds; Antonio Serra; Eberhard Schulz; Stephan Baldus; Matthias Lutz; Christiane Pohlmann; Jana Kurucova; Peter Bramlage; David Messika-Zeitoun Journal: BMC Cardiovasc Disord Date: 2017-01-05 Impact factor: 2.298