Mortality, risk indicators for death, and mode of death in younger and elderly patients during five years after coronary artery bypass graft

Background: The number of elderly patients who may be candidates for corona ry artery bypass graft (CABG) for severe coronary artery disease has increa sed. Cardiac surgery in the elderly is a high-risk procedure because many o f these patients have concomitant systemic disease and other disabilities. Hypothesis: The study was undertaken to evaluate mortality,risk indicators for death, and mode of death in younger and elderly patients during 5 years after CABG. Methods: The study included all patients in western Sweden who underwent CA BG without concomitant valve surgery and without previously performed CABG between June 1988 and June 1991. In all, 2,000 patients, of whom 953 (48%) were greater than or equal to 65 years, were divided into two age groups (< 65 years and greater than or equal to 65 years). Results: Compared with the younger patients, the elderly had a relative ris k of death of 2.3 (95% confidence interval 1.8-3.0). The increased risk of death in the elderly was significantly more marked in men, in patients with more severe angina pectoris, and in patients without a history of cerebrov ascular diseases. The mode and place of death appeared similar regardless o f age; neither was there marked difference in symptoms of angina pectoris a mong survivors 5 years after CABG. Conclusion: Compared with patients < 65 years, the elderly have more than t wice as high a risk of death during the subsequent 5 years, and this risk i s higher in men, in patients with severe symptoms of angina pectoris, and i n those with no history of cerebrovascular disease.