Coronary artery bypass grafting in elderly patients. In-hospital results and long-term follow-up

Background. Taking into account the steady increase in the number of elderl y patients requiring coronary artery bypass grafting, we sought to analyze the in-hospital and long-term evolution of a group of elderly patients (gre ater than or equal to 75 years) who underwent coronary artery bypass grafti ng, and to identify clinical predictors of mortality and long-term symptoms . Methods. Between April 1996 and February 2000, 207 patients older than 75 y ears of age who had undergone coronary bypass grafting were propectively an d consecutively analyze. Mean age was 78.4 +/- 2.7. Results. An average of 2.6 grafts/patients was constructed. Left mammary ar tery was used in 93% of patients. The in-hospital incidence of heart failur e, atrial fibrillation, preoperative infarction and stroke was 38%, 29%, 4. 8% and 2.8% respectively. The in-hospital mortality rate was 5.8%. Mean fol low-up was 18 months (25(th) an 75(th) percentiles 9-29). Late mortality ra te was 4.1% in eight patients. Excluding the in-hospital deaths, the estima ded probability of survival (Kaplan-Meier) at 3 years was 94% and the survi val freedom from symptoms was 86%. A multivariate analysis showed that only age was predictor of in-hospital mortality (OR 1.16, p = 0.009). Only peri pheral vascular disease was found as a predictor of symptoms during the lon g-term follow-up (p = 0.001). Conclusions. In this series of senile patients who underwent coronary surge ry, those of an older age (> 80 years) showed a higher risk of in-hospital mortality. The presence of peripheral vascular disease is useful in the pro gnosis assessment of the group.