August 3, 2026
View Full PaperOutcomes of Coronary Artery Bypass Graft Surgery in 24 461 Patients Aged 80 Years or Older
Key Result
Coronary artery bypass graft surgery in patients aged ≥80 years had significantly higher in-hospital (11.5% vs 4.4%) and 3-year mortality (28.8% vs 13.1%) compared to patients aged 65-70 years.
Key Points
- To analyze the outcomes of coronary artery bypass graft surgery in patients aged 80 and older.
- Examined Medicare data from 1987 to 1990 involving 24,461 patients aged 80 years or older.
- Compared outcomes with Medicare patients aged 65 to 70 years.
- In-hospital mortality was 11.5% for octogenarians compared to 4.4% for younger patients.
- 1-year mortality was 19.3% versus 7.9% for patients aged 65 to 70 years.
- 3-year mortality rates were 28.8% for patients aged 80 and older versus 13.1% for younger patients.
Study Design
Type
Cohort (n=24,461)
Multicenter
Yes
Structured PICO
What are the outcomes and costs of coronary artery bypass graft surgery in patients aged >= 80 years compared to those aged 65 to 70 years?
P
Population
24,461 Medicare patients aged 80 years or older who underwent coronary artery bypass graft surgery between 1987 and 1990, compared with patients aged 65 to 70 years.
E
Exposure
Coronary artery bypass graft (CABG) surgery
C
Comparator
Medicare patients aged 65 to 70 years who underwent coronary artery bypass graft surgery
O
Outcome
In-hospital, 1-year, and 3-year mortality rates, postoperative hospital stays, charges, and costshard clinical
CABG in patients aged 80 or older carries significantly higher procedural risks, mortality, and costs compared to younger patients, though long-term survival mirrors the general octogenarian population.
Main Result
Absolute Event Rate: 11.5% vs 4.4%
Abstract
BACKGROUND: Coronary artery bypass graft surgery is increasingly common in patients of age > or = 80 years. Single-institution reviews have cited a wide range of mortality results after bypass surgery in this age group, in part because of limited sample sizes. Using claims data, we examined recent national trends in the use and outcomes of bypass surgery in the very elderly. METHODS AND RESULTS: From an examination of Medicare data from 1987 through 1990, we identified 24, 461 patients of age > or = 80 years who underwent bypass surgery. We compared surgical outcomes in these patients with those in Medicare patients of age 65 to 70 years. We found that the national use of bypass surgery in patients of age > or = 80 years increased 67% between 1987 and 1990. Compared with patients of age 65 to 70 years, the very elderly had significantly longer postoperative hospital stays (mean, 14. 3 versus 10. 4 days), higher charges (mean, 48, 200 versus 38, 000), and greater costs (mean, 27, 200 versus 21, 700). In-hospital (11. 5% versus 4. 4%), 1-year (19. 3% versus 7. 9%), and 3-year mortality rates (28. 8% versus 13. 1%) after bypass surgery were also significantly higher in patients of age > or = 80 years compared with younger patients. Although their initial surgical risk was high, octogenarians who underwent bypass surgery had a long-term survival rate similar to that of the general US octogenarian population. CONCLUSIONS: The use of bypass surgery in patients of age > or = 80 years in increasing. These very elderly patients face high surgical risks and accumulate significant hospital expenses. Further research is indicated to determine whether the long-term benefits from bypass surgery in the very elderly outweigh the increased procedural risks.