Abstract
ObjectiveAs the population ages, increasing number of older patients are undergoing adult cardiac surgery. The purpose of the study is to assess the impact of age on postoperative outcomes in patients that undergo coronary artery bypass grafting (CABG).MethodsPatients that are ≥70 years old who underwent CABG were selected from the Nationwide/National Inpatient Sample from 2010 to 2015 using ICD-9-CM diagnosis and procedure codes. The patients who were 70–79 years old were compared to patients aged 80–89 years old to determine if the age difference of the patients had an impact on surgical outcomes. In addition, a secondary endpoint is to compare surgical outcomes between the 2 genders of the patients 80–89 years old. The rates of postoperative complications, and mortality were compared.ResultsA total of 67,568 patients were identified who were ≥ 70 years old and underwent CABG. Compared to the Septuagenarians, the Octogenarians were more likely to develop cardiac complications (OR [odds ratio] =1.20, 95% CI [confidence interval] 1.12–1.23. They were also more likely to develop renal complications (P < 0001), and respiratory complications (P < 0001). The Octogenarians were also more likely to bleed postoperatively (P < 0.0001) and have a higher mortality (P < 0001). Furthermore, the female Octogenarians had a higher mortality (OR 1.25 95% CI 1.07–1.46) compared to males in the same age group.ConclusionsThe patients who were ≥ 80–89 years old had worse postoperative outcomes. The Octogenarians who were females had a higher mortality compared to their male counterparts.
Highlights
As the population ages, an increasing number of older patients are being referred for coronary artery bypass grafting (CABG) for cardiovascular diseases [1, 2]
The aim is to determine whether Septuagenarians have better results compared to Octogenarians and assess the effect of gender in octogenarians on postsurgical outcomes. The data for this project was obtained from the AHRQ (Agency for Healthcare Research and Quality) HCUP (Healthcare Cost and Utilization Project) Nationwide/ National Inpatient Sample (NIS) for the years 2010– 2015
The study population included patients aged ≥70 years old who were hospitalized for coronary artery disease (CAD) and underwent CABG during seven days after hospitalization
Summary
An increasing number of older patients are being referred for coronary artery bypass grafting (CABG) for cardiovascular diseases [1, 2]. Octogenarians, as the fastest growing stratum of the population and with the highest prevalence of coronary artery disease, are more often being sent to cardiothoracic surgeons for surgical revascularization (Fig. 1) [3]. One of the concerns of operating on older patients is often the trepidation of poor surgical outcomes. The same alarm is shared by cardiologist who consider Octogenarians at the highest risk for procedural complications during percutaneous coronary interventions (PCI) owing to their greater prevalence of associated comorbidities and more depressed cardiac function [5, 6]. There is no clear consensus in the literature on the impact of age on CABG patient outcomes
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