Complication in octogenarians after isolated CABG surgery—Analysis of data from the ASCTS database project

Diem Dinh, Baki Billah, Cheng-Hon Yap, Gilbert Shardey, Christopher M. Reid, on behalf of the ASCTS Database Group

Research output: Contribution to journalMeeting AbstractOtherpeer-review

Abstract

Introduction: The increasing incidence of cardiovascular disease with age, together with the extension of life expectancy, is leading to an increased proportion of elderly patients being considered for CABG surgery. Previous studies have suggested that octogenarians undergoing isolated CABG are at higher risk for postoperative complications [1].There isnoregistry data from multi-institutions on the outcome for octogenarians in Australia, whichmay be different due to differing patient characteristics. Aim: To evaluate the incidence of postoperative complications in octogenarians having isolated CABG surgery. Methods: All patients recorded in the ASCTS database having isolatedCABGprocedures between 1 July 2001 and 31 December 2006 (data from 6 Victorian Public Hospitals) were reviewed. Categorical variables were analysed using simple binary logistic regression and continuous variables were analysed using non-parametric Mann–Whitney test. A p-value of less than 0.05 was regarded as significant. Stata version 9.2 was used for the analysis. Results: There were 573 octogenarians (5.56%) in the entire group of 10,299 patients having isolated CABG. The mean age of the non-octogenarians was 64.8±9.6 years. The majority of patients underwent elective/urgentCABG surgery and only 6% underwent emergency/salvage CABG procedures. The mortality rate was significantly higher in octogenarians (4.1%) compared to non-octogenarians (1.2%) undergoing elective/urgent isolated CABG (p < 0.001). There was no significant difference in the mortality rate between octogenarians (10.3%) and non-octogenarians (10.0%) referred for emergency/salvage CABG surgery. Octogenarians who underwent elective/urgent surgery were more likely to require readmission to ICU (4.3% vs. 2.6%, p = 0.02) and developnewrenal failure (8.4% vs. 3.3%, p < 0.001). Octogenarians also had a longer post-procedure length of stay (median of 8 days vs. 6 days, p < 0.001), ICU stay (median of 25 h vs. 22 h, p < 0.001) and ventilation time (median of 10 h vs. 8 h, p = 0.029). There was no difference in the rate of deep sternal wound infection (0.8% vs. 0.7%, p = 0.90) and return to theatre for haemorrhage (3.4% vs. 2.3%, p = 0.12) between octogenarians and nonoctogenarians. Discussion and conclusion: Octogenarians undergoing isolated CABG required increased resource utilisation, and had a significant higher postoperative morbidity and 30-day mortality. The mortality rate in the octogenarians following isolated CABG in Victoria is on par if not lower than that reported in the UK (2003 crude mortality rate of 4.7% for over 75 years of age). Age alone has been shown to be an independent predictor to influence outcome after cardiac surgery.

Original languageEnglish
Pages (from-to)65-66
Number of pages2
JournalHeart Lung and Circulation
Volume18
Issue number1
DOIs
Publication statusPublished - 2 Feb 2009
EventThe Australasian Society of Cardiac and Thoracic Surgeons Annual Scientific Meeting 2007 - Sheraton Noosa Resort and Spa, Noosa Heads, Australia
Duration: 16 Oct 200720 Oct 2007
Conference number: 5th

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