Predictors of outcome after coronary artery bypass grafting in patients older than 75 years of age.
Articles > Article · 2003
Authors: Fatih Islamoglu, Hasan Reyhanoglu, Ozbek Berber, Mustafa ÖZBARAN, Suat Buket, Münevver Yüksel, Ali Telli, Isa Durmaz
Medical science monitor : international medical journal of experimental and clinical research, International, 2003, vol 9, pp CR369-76
Summary
BACKGROUND: This study was designed to identify risk factors affecting mortality and morbidity in patients older than 75 years who underwent coronary artery bypass grafting (CABG) with cardiopulmonary bypass. MATERIAL/METHODS: The preoperative, perioperative, and postoperative data of 116 patients older than 75 years who underwent isolated CABG from January 1997 through April 2002 were evaluated retrospectively. Preoperatively, 82 patients (70.7%) were in CCS class III-IV and 65 (56%) were in NYHA class III-IV. Besides mortality, morbidity and survival rates, the statistical significance of predictors of outcome were investigated. RESULTS: Overall mortality and hospital mortality rates were 12.9% (15 patients) and 4.3%, (5 patients), respectively. Postoperative complications were observed in 56 patients (48.3%). In 25.1+/-17.6 months of follow-up, 96 (86.5%) and 101 (91%) of the surviving 111 patients (95.7%) were in NYHA class I and CCS class I, respectively. Prolonged cross-clamp time (>50 min) (p=0.018), COPD (p=0.028), and emergency operation (p=0.001) were found to be the determinants of postoperative complications. The cumulative 5-year survival rate was 77.2 +/-0.8%. CONCLUSIONS: Elective CABG in older patients with shorter bypass and cross-clamp times, after the management of comorbid disease, such as COPD, is a safe procedure with low mortality and morbidity rates, showing postoperative improvements in functional capacity and angina class.