Why the study?
The study was conducted to identify in-hospital outcomes in younger (≤ 65 years) versus older (> 65 years) patients after CABG by analyzing the effect of age on adverse events following on-pump or off-pump surgery.
Does older age (> 65 years) increase the risk of adverse in-hospital outcomes in patients undergoing on-pump or off-pump CABG compared to younger age (≤ 65 years)?
Does older age (> 65 years) increase the risk of adverse in-hospital outcomes in patients undergoing on-pump or off-pump CABG compared to younger age (≤ 65 years)?
Older age (>65 years) is significantly associated with worse in-hospital outcomes, including mortality and stroke, particularly after on-pump CABG.
Older patients face higher in-hospital risks after CABG, especially POAF; leaves open whether off-pump reduces age-related mortality differences.
OBJECTIVES: We aimed to identify in-hospital outcomes in young (≤ 65 years) and old (> 65 years) patients after coronary artery bypass grafting (CABG) by analyzing the effect of age on adverse events after on-pump or off-pump CABG. METHODS: Patients older than 65 years were defined as older patients and others were defined as younger patients. The qualitative data were compared by chi-square or Fisher's exact tests. The quantitative data were compared by the two-sample independent t-test or Mann-Whitney U test. Multifactor binary logistic regression was used to control for confounders and to investigate the effect of age on dichotomous outcome variables such as death. RESULTS: In the on-pump CABG population, the postoperative in-hospital mortality, the incidence of postoperative symptomatic cerebral infarction (POSCI) and postoperative atrial fibrillation (POAF) was higher in older patients than in younger patients (P value < 0.05), and age > 65 years was associated with postoperative in-hospital mortality (OR = 2.370, P value = 0.031), POSCI (OR = 5.033, P value = 0.013), and POAF (OR = 1.499, P value < 0.001). In the off-pump CABG population, the incidence of POAF was higher in older patients than in younger patients (P value < 0.05), and age > 65 years was associated with POAF (OR = 1.392, P value = 0.011). CONCLUSION: In-hospital outcomes after CABG are strongly influenced by age. In on-pump CABG, the risk of postoperative death, POSCI, and POAF was higher in older patients, and in off-pump CABG, the risk of POAF was higher in older patients.
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Zhang et al. (2023) studied this question.
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