Postoperative Outcome of High-Risk Octogenarians Undergoing Cardiac Surgery: A Multicenter Observational Retrospective Study

Pořízka, Michal; Kunstýř, Jan; Vanek, Tomas; Nejedly, Michal; Buckova, Jana; Mokrejs, J; Mošna, František

doi:10.5761/atcs.oa.16-00280

Cited by 6 publications

(5 citation statements)

References 26 publications

(23 reference statements)

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“…13 Older people usually have a number of comorbidities, so the risk of surgery is part of the overall risk. 14 By examining the underlying factors, a better understanding of the role of comorbidities and the distinct role of the aging process in increasing the risk of postoperative complications can be found.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Redo operation, complication rate and risk predictors, a cross sectional study

Sakhaee¹,

Saberi²,

Alemohammad³

et al. 2022

JACCOA

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Background: Considering the effect of heart disease and its post-surgical complications on the patient's quality of life, identifying risk predictors for complications after surgery and the patient's clinical course can help us to improve the quality of primary care after surgery, reduce complications and improve the patient's recovery after surgery. This study aims to determine postoperative complication prevalence and related risk predictors. Material and methods: In this cross-sectional study, the clinical course after cardiac reoperation of patients in the cardiac operating room of Imam Khomeini Hospital during the years 2014-2021was studied. Patients who have had a stroke in the past six months, heart failure, and EF less than 25% were excluded from the study. This study investigates the relationship between preoperative and intraoperative conditions of patients (age, sex, hemoglobin, serum creatinine, blood product transfusion, and pump time) and postoperative complications (death, AKI, bleeding, CVA, and pulmonary complication. Results: This study examined 461 cardiac reoperation patients with a mean age (44.54±18.35). The most common complications were bleeding (8.24%), death (8.2%), and AKI (19.65$), respectively. In this study, there was a significant difference in terms of age, hemoglobin level, creatinine level, pump time, and blood product transfusion in patients faced with death and AKI compared to uncomplicated patients. Patients with postoperative bleeding received more blood products and had a longer pump time than uncomplicated patients, which was statistically significant. Conclusion: In this study, there was a significant difference between deceased and uncomplicated patients after cardiac reoperation in terms of age, anemia, pre operative renal failure, and receiving more blood products during surgery. This difference, however, does not necessarily create a causal relationship; but suggests some risk predictors for redo cardiac surgery.

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Section: Discussionmentioning

confidence: 99%

Cardiac Redo operation, complication rate and risk predictors, a cross sectional study

Sakhaee¹,

Saberi²,

Alemohammad³

et al. 2022

JACCOA

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“…9 Indeed, the risk of cardiac surgery in octogenarian has been reported to be extremely high. 10 To decrease the burden of age, alternative coronary artery bypass procedures have been developed with either off-pump CABG or minimally invasive approach. Meta-analysis studies comparing on- and off-pump CABG in octogenarians reported that in-hospital mortality, rate of stroke, and length of hospital stay were lower in off-pump CABG.…”

Section: Discussionmentioning

confidence: 99%

Benefit of Robotic Beating-Heart Totally Endoscopic Coronary Artery Bypass in Octogenarians

Kuwabara

McCrorey

Patel

et al. 2019

Innovations�(Phila)

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Objective An important advantage of robotic beating-heart totally endoscopic coronary artery bypass (TECAB) is early functional recovery, in which fragile patients like octogenarians (age >80 years) benefit most. The aim of this study was to investigate the safety and feasibility of TECAB in octogenarians. Methods We retrospectively reviewed patients undergoing TECAB from July 2013 to September 2017 at our institution. Perioperative outcomes of octogenarian patients and that of younger patients were compared. Results Of 308 patients who underwent TECAB, 28 patients (9.1%) were octogenarians (mean age 83.8 ± 3.0 years). Octogenarians had a higher rate of hypertension and atrial fibrillation compared to younger patients. TECAB was successfully performed without conversion to any larger incisions in octogenarians. Mean operative time (299 ± 83 minutes vs 281 ± 89 minutes, P = 0.309) and the rate of multivessel bypass (60.7% vs 58.2%, P = 0.798) were similar between octogenarians and younger patients. New atrial fibrillation was observed more frequently in octogenarians compared to younger patients (35.7% vs 18.6%, P = 0.031). Mean length of hospital stay was similar between the 2 groups (octogenarians: 3.9 ± 1.8 days vs younger patients: 3.5 ± 3.0 days, P = 0.475). Twenty-two octogenarians (78.6%) were discharged directly to home. In-hospital mortality was zero in octogenarians. Conclusions Robotic beating-heart TECAB had favorable results in octogenarians with acceptable morbidity and mortality and excellent short length of stay similar to younger patients.

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“…Cardiac surgery is the most common of thoracic surgery, more than 70 000 patients in Japan undergo cardiac surgery annually, 3 in particularly the absolute number of older patients undergoing cardiac surgery is increasing. 4 In the consideration of cardiac surgery for older patients, functional decline and the need for long-term care have received increasing attention as essential outcomes in recent years.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Protocol for a multicentre, prospective observational cohort study in Japan: association among hospital-acquired disability, regular exercise and long-term care dependency in older patients after cardiac surgery

et al. 2021

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IntroductionCardiac surgery for older patients, postoperative functional decline and the need for long-term care have received increasing attention as essential outcomes in recent years. Therefore, prevention of functional decline and long-term care dependency after cardiac surgery are important; however, our current understanding of postoperative functional trajectory and effects of postoperative regular exercise on long-term functional decline and long-term care dependency is limited. Therefore, we will conduct a multicentre, prospective cohort study to (1) examine the effect of hospital-acquired disability on long-term functional decline and long-term care dependency and (2) investigate the favourable effect of postoperative regular exercise on long-term functional decline and long-term care dependency in older patients after cardiac surgery.Methods and analysisWe designed a prospective, multicentre cohort study to enrol older patients aged≥65 years undergoing elective coronary artery bypass graft or valve surgery. We will conduct medical record reviews to collect data on patient demographics, comorbidities, operative details, progression of in-hospital postoperative cardiac rehabilitation and functional trajectory from a few days before cardiac surgery to the day before hospital discharge. They will be followed up for 2 years to obtain information on their health status including functional status, regular exercise and clinical events by mail. Primary endpoints of this study are long-term functional decline and long-term care dependency after cardiac surgery. Secondary endpoints are readmission due to cardiac events or all-cause mortality.Ethics and disseminationThe study protocol was approved by the Ethics Committee of the Department of Physical Therapy, Faculty of Health Science, Juntendo University, and of each collaborating hospital. We obtained written informed consent from all study participants after the description of the study procedures. Publication of the study results is anticipated in 2025.

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Postoperative Outcome of High-Risk Octogenarians Undergoing Cardiac Surgery: A Multicenter Observational Retrospective Study

Cited by 6 publications

References 26 publications

Cardiac Redo operation, complication rate and risk predictors, a cross sectional study

Cardiac Redo operation, complication rate and risk predictors, a cross sectional study

Benefit of Robotic Beating-Heart Totally Endoscopic Coronary Artery Bypass in Octogenarians

Protocol for a multicentre, prospective observational cohort study in Japan: association among hospital-acquired disability, regular exercise and long-term care dependency in older patients after cardiac surgery

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