Document Detail


Coronary artery bypass surgery in octogenarians: outcomes in a tertiary referral university hospital in a developing country.
MedLine Citation:
PMID:  14659861     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The number of people older than 80 years is increasing worldwide and many of these patients are being referred for coronary artery bypass surgery (CABG). Several recent reports from the USA and Europe have shown that CABG can be performed in octogenarians with an acceptable risk. However, data from developing countries regarding this subject is lacking. The objective of this study was to analyze the clinical characteristics and in-hospital events of octogenarian patients undergoing CABG at a tertiary referral university hospital in a developing country. METHODS: The study included 28 consecutive octogenarian patients who underwent CABG at the American University of Beirut, between January 1998 and December 2000. The medical records of these patients were reviewed for demographic information, clinical and catheterization findings, operative characteristics, and in-hospital events (death, myocardial infarction, and stroke). RESULTS: The mean age of the study group was 82 +/- 2 years and 75% were males. Seventy-eight percent of the patients had an acute myocardial infarction or unstable angina prior to CABG. All of the patients were in NYHA class I or II and none of the operations were done on an emergent basis. The mean ejection fraction was 48 +/- 7%. Eighty-six percent of patients had multivessel disease and four patients had aortic valve replacement (AVR) concomitantly with the CABG. The in-hospital mortality was 0%. Three patients (11%) had a post-operative myocardial infarction, and one patient (4%) had a stroke. The mean post-operative stay was 9 +/- 7 days with only three patients (11%) staying for more than 14 days. The multivariate predictors of in-hospital cardiovascular events were concomitant AVR (P=0.01), and an ejection fraction <40% (P=0.03). CONCLUSION: In carefully selected octogenarian patients who are clinically stable in NYHA class I or II, and where the operation is not done on an emergent basis, CABG can be performed with an acceptable risk and a low in-hospital mortality.
Authors:
Habib A Dakik; Hwaida Hannoush; Mounir Y Obeid
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  92     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-08     Completed Date:  2004-04-29     Revised Date:  2006-07-12    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  253-6     Citation Subset:  IM    
Affiliation:
Division of Cardiology, American University of Beirut-Medical Center, PO Box 11-0236/A38, Beirut, Lebanon. hd01@aub.edu.lb
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over*
Coronary Artery Bypass / mortality*
Developing Countries*
Female
Hospital Mortality
Hospitals, University
Humans
Lebanon / epidemiology
Length of Stay / statistics & numerical data
Logistic Models
Male
Myocardial Infarction / epidemiology
Postoperative Complications / epidemiology
Referral and Consultation
Retrospective Studies

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