Cardiac surgery in 260 octogenarians: a case series

BMC Anesthesiol. 2015 Jan 26;15(1):15. doi: 10.1186/1471-2253-15-15. eCollection 2015.

Abstract

Background: The elderly undergo cardiac surgery more and more frequently, often present multiple comorbidities, assume chronic therapies, and present a unique physiology. Aim of our study was to analyze the experience of a referral cardiac surgery center with all types of cardiac surgery interventions performed in patients ≥80 years old over a six years' period.

Methods: A retrospective observational study performed in a university hospital. 260 patients were included in the study (3.5% of the patients undergoing cardiac surgery in the study period).

Results: Mean age was 82 ± 1.8 years. Eighty-five percent of patients underwent elective surgery, 15% unplanned surgery and 4.2% redo surgery. Intervention for aortic valve pathology and coronary artery bypass grafting were performed in 51% and 46% of the patients, respectively. Interventions involving the mitral valve were the 26% of the total, those on the tricuspid valve were 13% and those on the ascending aortic arch the 9.6%. Postoperative low output syndrome was identified in 44 patients (17%). Mortality was 3.9% and most of the patients (91%) were discharged from hospital in good clinical conditions. Hospital mortality was lower in planned vs unplanned surgery: 3.8% vs 14% respectively. Chronic obstructive pulmonary disease (OR 9.106, CI 2.275 - 36.450) was the unique independent predictor of mortality.

Conclusions: Clinicians should be aware that cardiac surgery can be safely performed at all ages, that risk stratification is mandatory and that hemodynamic treatment to avoid complications is expected.

Keywords: Anesthesia; Cardiac surgery; Complications; Intensive care; Mortality; Octogenarian.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Cardiac Surgical Procedures / adverse effects
  • Cardiac Surgical Procedures / mortality
  • Cardiac Surgical Procedures / statistics & numerical data*
  • Female
  • Hospital Mortality
  • Humans
  • Italy / epidemiology
  • Male
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Postoperative Complications / epidemiology*
  • Retrospective Studies