Key result
Open-heart surgery in elderly patients is associated with ~63% lower mortality versus younger patients.
Why the study?
Does open-heart surgery have comparable mortality outcomes in elderly patients compared to younger patients in a developing country?
Cohort (n=145)
Does open-heart surgery have comparable mortality outcomes in elderly patients compared to younger patients in a developing country?
Absolute Event Rate: 2.2% vs 6%
Elderly patients undergoing open-heart surgery in a developing country have comparable or better hospital mortality rates than younger patients, suggesting age alone should not preclude surgery.
May support surgical candidacy in elderly patients in developing countries; hypothesis-generating and requires prospective confirmation.
To evaluate and compare the outcome of open-heart surgery in elderly patients with a concurrent group of younger patients in a developing country, data of all adult patients who underwent open-heart surgery during the period of 3 years from January 1999 to December 2001 were collected prospectively. Demographic data such as age and gender, other data such as preoperative diagnoses, comorbid illnesses, type of surgery, time of cardio-pulmonary bypass, length of stay and hospital outcome were recorded. The characteristics of patients above the age of 65 years were compared with a concurrent cohort of patients aged less than 65 years. One hundred and forty-five adult patients underwent open-heart surgeries in 3 years, and the overall mortality rate was 4.8%. The much common surgeries were coronary artery bypass grafting, valve repair/replacement surgery and surgery for adult congenital heart diseases. Forty-five (31%) patients were above the age of 65 years. The mortality rate was 2.2% for patients who were aged 65 years and above, in comparison with that of the concurrent cohort of younger patients (6%). This was probably because of more number of surgeries for congenital heart diseases in the latter group. However, even with other surgeries such as coronary artery bypass grafting, the elderly group of patients did equally well as the younger group. Elderly patients tolerate cardiac surgery well, and age should not be an exclusive criterion to decide against open-heart surgery.
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Hariharan et al. (2005) conducted a cohort in Open-heart surgery (n=145). Age ≥65 years vs. Age <65 years was evaluated on Mortality rate. Elderly patients (≥65 years) undergoing open-heart surgery had a mortality rate of 2.2% compared to 6% in younger patients.
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