Document Detail


Determinants of operative mortality in octogenarians undergoing coronary bypass.
MedLine Citation:
PMID:  7574944     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The elderly segment of the population is increasing rapidly, and surgeons are being asked to consider patients more than 80 years old as candidates for coronary bypass. The objective of this study was to identify risk factors that may adversely affect mortality as well as analyze functional outcomes and survival in octogenarians undergoing coronary bypass. METHODS: From July 1989 through February 1994, 300 consecutive patients 80 years of age and older underwent coronary artery bypass grafting. There were 176 men (58.7%) and 124 women (41.3%) with a mean age of 80.9 years (range, 80 to 99 years). Preoperatively, 274 patients (91.3%) had disabling angina, 76 (25.3%) had left main coronary stenosis greater than 50%, and 293 patients (98.3%) were in New York Heart Association class III or IV. RESULTS: The overall hospital mortality was 11.0% (33/300) with an elective mortality of 9.6% (23/240), urgent mortality of 11% (5/45), and emergent mortality of 33.3% (5/15). Significant independent predictors of operative mortality were preoperative renal dysfunction, postoperative pulmonary insufficiency, postoperative renal dysfunction, use of intraaortic balloon pumping, and sternal wound infection. The actuarial survival for patients discharged from the hospital was 74.6% +/- 5.6% (standard error of the mean) at 54 months. CONCLUSIONS: A favorable outcome may be expected when coronary artery bypass grafting is performed in patients 80 years of age or older with severe angina.
Authors:
D B Williams; R G Carrillo; E A Traad; C H Wyatt; R Grahowksi; S H Wittels; G Ebra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  60     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1995 Oct 
Date Detail:
Created Date:  1995-11-08     Completed Date:  1995-11-08     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1038-43     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Mount Sinai Medical Center of Greater Miami, Miami Beach, Florida.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over*
Coronary Artery Bypass / mortality*
Female
Humans
Male
Postoperative Complications
Retrospective Studies
Risk Factors
Survival Analysis
Survival Rate
Treatment Outcome
Comments/Corrections
Comment In:
Ann Thorac Surg. 1995 Oct;60(4):875-6   [PMID:  7574988 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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