Background. Nationwide, cardiac surgery is being performed more frequently
in patients aged 80 years and older.
Methods. One hundred four octogenarians undergoing a variety of heart-lung
procedures were prospectively studied between 1995 and 1998 for comparison
with similar patients aged 65 to 75 years (n = 351).
Results. Octogenarians were more likely to be of female gender, and be nond
iabetic than the younger group. The 30-day mortality rate for patients aged
65 to 75 years was 3.4% (12 of 351 patients), versus 13.5% (14 of 104) for
patients aged 80+ (p = 0.0004), which ranged from 2% (1 of 50) in nonemerg
ent coronary artery bypass grafting to 75% (3 of 4) in double valve procedu
res. Complications occurring more frequently in octogenarians were severe l
ow output state, reintubation, and atrial fibrillation. Elders experienced
a longer intensive care (69.2 versus 43.3 hours, p = 0.002) and postoperati
ve stay (10.09 versus 7.45 days, p = 0.001), and were discharged to a skill
ed nursing facility more often than younger patients (47% versus 21.1%, p =
0.0001). Total direct costs were $4,818 higher in the octogenarian group (
p = 0.0007).
Conclusions. Although emergency operations and complex procedures carried h
igh risks for the octogenarian, the majority of these patients can be offer
ed operation with short-term morbidity, mortality, and resource use that on
ly modestly exceeds that of younger patients. (C) 2001 by The Society of Th
oracic Surgeons.