OPEN-HEART-SURGERY IN A GROWING GERIATRIC POPULATION - PATIENT SELECTION AND RISK-FACTORS TO BE CONSIDERED

Aims This report describes our experience with cardiac surgery in elde rly patients and aims to ascertain predictors of poor outcome. Patient s Five hundred and ninety-eight (598) consecutive patients aged 75 yea rs and older underwent cardiac surgery at the Department of Cardiothor acic Surgery, University Hospital of Lund, Sweden, between January 198 0 and December 1993. There were 324 men (54%) and 274 women (46%); the ir age varied between 75 and 91 years (mean age +/- SD, 77.8 +/- 2.6 y ears). One hundred and twenty-nine patients underwent aortic, mitral o r combined valve replacement, 273 patients underwent exclusive coronar y revascularization (CABG) alone and 109 underwent a surgical procedur e which included valve replacement and concomitant CABG. The remainder (87 patients) underwent other, more complex surgical procedures.Resul ts The 30-day or in-hospital mortality rate was 5.5% (0.8% for valve r eplacement, 5.1% for CABG, 5.5% for valve replacement with concomitant CABG, and 12.6% for other procedures). Concomitant severe diseases oc curred in 34.9% of the patients. All surviving patients were evaluated during June 1994. None of the patients was lost to follow-up. The 566 long-term survivors have been followed for an average of 23.0 months (median 21; range 1-53 months). Late mortality was 12.0% in the 566 ho spital survivors. Only 17 patients experienced late complications (aft er hospital discharge), as an adverse effect linked to heart surgery. Coronary Artery Dis 9:365-372 (C) 1998 Lippincott Williams & Wilkins.