Cardiac surgery in octogenarians. Peri-operative outcome and long-term results

Kolh, Philippe; Kerzmann, Arnaud; Lahaye, Laurent; Gérard, Paul; Limet, Raymond

doi:10.1053/euhj.2000.2443

Cited by 195 publications

(133 citation statements)

References 27 publications

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“…With this reason, it has been emphasized that the advanced age patients have been required to be operated without waiting till NYHA class IV (11,15). In our study, it has been determined that the patients having operation with the class III-IV complaints have been a risk factor for the hospital mortality in the logistic regression analysis.…”

Section: Mortality Morbidity and Risk Factorsmentioning

confidence: 83%

The quality of life after cardiac surgery in octogenarians and evaluation of its early and mid-term results

Kara¹,

Ay²,

Köksal³

et al. 2012

Anadolu Kardiyol Derg

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Objective: The aim of this study is to evaluate our early and mid-term results and the qualities of life of the patients aged eighty years or older who underwent heart surgery. Methods: Eighty-eight patients aged 80 years and older who underwent open-heart surgery at Göztepe Şafak Hospital between May 2004 and December 2010 have been included to the study. This study was designed as two-stage: in the first stage, determinants of survival were analyzed retrospectively. In the second stage, the quality of life of survived patients was evaluated by using Short-Form 36 (SF-36), Turkish version in the cross-sectional study. The statistical analysis was performed using Fischer's exact, Pearson Chi-square test, Student t-test, Mann-Whitney U test and logistic regression analysis. Results: In the logistic regression analysis; the left ventricular ejection fraction as <50% (OR: 11.02, 95% CI: 2.6-46.6, p<0.05), application of redo surgery (OR: 8.3, 95% CI: 1.04-66.6, p<0.05), coronary bypass and mitral surgery procedures in the same session (OR: 9.2, 95% CI: 1.6-53.7, p<0.05), left main coronary lesion as >50% (OR: 4.3, 95% CI: 1.1-17.7, p<0.05), preoperative creatinine as >1.8 mg/dl (OR: 14.1, 95% CI: 2.6-76.1, p<0.01), New York Heart Association class III-IV (OR: 4.9, 95% CI: 1.2-20.1, p<0.05), chronic obstructive pulmonary disease (OR: 10.3, 95% CI: 2.5-41.7, p<0.01) were found to be risk factors of hospital mortality. Physical functions, social functions and all sub-scales other than the role limitation depending on the emotional situation were evaluated as general population mean or above. Conclusion: We think that with a successful heart surgery in patients aged 80 years and older under appropriate conditions, their life qualities and mean life expectations can return to normal and they can lead a symptomless life. (Anadolu Kardiyol Derg 2012; 12: 352-8)

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Section: Mortality Morbidity and Risk Factorsmentioning

confidence: 83%

The quality of life after cardiac surgery in octogenarians and evaluation of its early and mid-term results

Kara¹,

Ay²,

Köksal³

et al. 2012

Anadolu Kardiyol Derg

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show abstract

“…Thus, surgery in the octogenarian must take into account a number of factors, such as lack of synchronism between physiological age and chronological age, quality of life, risk/benefit ratio and increase in health care costs, an element that is gaining more and more importance [7,19,23,25]. The issue has been settled for other surgical pathologies such as hip fractures [10] or cardiac valve replacement [12]. Secondly, more and more people aged over 80, at greater risk of ground-level falls, have upper cervical spine injuries [19].…”

Section: Discussionmentioning

confidence: 99%

Anterior screw fixation of type IIB odontoid fractures in octogenarians

et al. 2011

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Purpose Type IIB odontoid fractures (OF) in elderly patients are life-threatening conditions. Optimal treatment of these fractures is still controversial. The aim of this study was to assess the clinical and radiological outcome of surgically treated type IIB OF by anterior screw fixation in octogenarians. Methods Eleven octogenarians with type IIB OF were operated using anterior screw fixation. Follow-up assessment included operative mortality and morbidity rates, long-term functional outcome and fracture union and stability. Results There was neither operative mortality nor morbidity. Five patients had excellent clinical outcome, two good outcome, one fair and three poor. Two patients died of unrelated causes 2 months after surgery. Radiographs showed stable bone union in four patients and stable fibrous union in five patients. Conclusions Given the results in this short series, we suggest that anterior screw fixation of Type IIB OF may be offered as primary treatment in octogenarians.

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“…Although there are many data concerning open-heart surgery (particularly CABG) in elderly patients, much less is known about early and late mortality rates, nonfatal adverse events, functional status and resource use in octogenarians undergoing valve surgery (5,(9)(10)(11)(12)(13)(14). Ours was one of the largest European studies of a wide range of isolated or combined complex valve surgical interventions and included postoperative complications, late functional status, and the risk factors associated with early and late death.…”

Section: Discussionmentioning

confidence: 99%