FUNCTIONAL-CAPACITY AFTER CARDIAC-SURGERY IN ELDERLY PATIENTS

Objectives. This study was performed to determine whether cardiac surg ery improves functional capacity in patients >70 years of age and to i dentify factors associated with good and poor functional results in th is age group. Background. Cardiac surgery has been used increasingly a mong older patients, but the effectiveness of surgery in this age grou p remains controversial. Methods. Self-reported functional capacity wa s assessed by the Duke Activity Status Index preoperatively and again 1 year after coronary artery bypass or valve replacement surgery in a total of 199 patients with a mean age of 76 years (range 70 to 91). Re sults. Functional capacity improved significantly after surgery (mean Duke Activity Status Index 27.9 at baseline vs. 36.8 at 12 months, p < 0.001), with improvements in most patients (74%). Six preoperative fa ctors were independent predictors of less improvement in functional ca pacity between baseline and 1 year: smoking, female gender, higher Cha rlson comorbidity index, syncope, previous cardiac operation and older age. Postoperative complications were also a highly significant predi ctor of lower functional capacity at 1 year. Conclusions. Most older p atients have meaningful improvements in functional capacity after card iac surgery, and clinical factors appear to modify the degree of impro vement attainable.