| 601 octogenarians undergoing cardiac surgery: outcome and comparison with younger age groups. | |
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MedLine Citation:
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PMID: 10320258 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Cardiac valve replacement and coronary artery bypass graft surgery (CABG) are being applied with increasing frequency in patients 80 years of age and older. METHODS: Six hundred one consecutive patients older than 80 years, undergoing cardiac surgery between 1976 and 1994 (CABG with saphenous vein graft, 329 [54.7%]; CABG with left internal mammary artery, 101 [16.8%]; CABG + valve, 80 [13.3%]; isolated aortic valve replacement, 71 [11.8%]; isolated mitral valve replacement, 18 [3.0%]), were studied retrospectively to assess short- and long-term survival. They were compared with 11,386 patients aged 60 to 69 years and 5,698 patients aged 70 to 79 years undergoing similar procedures during the same time interval. RESULTS: In comparison with patients 60 to 69 years old, more octogenarians were women (44.4% versus 25.6%, p<0.0001), had class IV angina (54.1% versus 38.9%, p<0.0001), and had congestive heart failure class IV (4.9% versus 3.0%, p = 0.0001). In-hospital death rates (9.1% versus 3.4%, p<0.0001) and stroke (5.7% versus 2.6%, p<0.0001) reflected these adverse clinical risk factors. However, Q-wave infarction tended to be less frequent (1.5% versus 2.6%, p = 0.102). Interestingly, hospital mortality (9.1% versus 6.7%, p = 0.028) was only slightly increased, and stroke (5.7% versus 4.7%, p = 0.286) was not more common in octogenarians than in patients 70 to 79 years old. Late-survival curves have similar slopes for the first 5 years in all clinical subgroups. However, after 5 years there is a more rapid decline in octogenarians than in younger age groups. Median 5-year survival was 55% for patients older than 80 years, 69% for patients 70 to 79 years, and 81% for patients 60 to 69 years old. CONCLUSIONS: When appropriately applied in selected octogenarians, cardiac surgery can be performed with acceptable mortality and excellent 5-year survival. |
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Authors:
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J M Craver; J D Puskas; W W Weintraub; Y Shen; R A Guyton; J P Gott; E L Jones |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 67 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 1999 Apr |
Date Detail:
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Created Date: 1999-05-25 Completed Date: 1999-05-25 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1104-10 Citation Subset: AIM; IM |
Affiliation:
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Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Angina Pectoris / complications Cerebrovascular Disorders / etiology Coronary Artery Bypass* / mortality Female Heart Failure / complications Heart Valve Prosthesis Implantation* / mortality Humans Male Middle Aged Postoperative Complications Retrospective Studies Survival Rate Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Ann Thorac Surg. 2000 Jan;69(1):317-8
[PMID:
10654556
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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