Key result
Open heart surgery in patients over 75 carries ~6% operative mortality with high 1-year survival.
Why the study?
Open heart surgery is considered high risk in elderly patients, and outcomes in patients above 75 years in regions with lower life expectancy are not well characterized.
Cohort (n=140)
No
May inform shared decision-making for selected patients over 75; leaves open prospective trials to confirm outcomes and mitigate neurological risk.
Objectives: Open heart surgery is considered as high risk procedure in elderly patients. We study the operative outcomes of open heart surgery in patients of age above 75 years in geography of world where life expectancy is around 67 years. Study Design: Retrospective Study. Setting: Research of Rawalpindi Institute of Cardiology (RIC). Periods: From January 2014 to December 2018. Material & Methods: Demographic and baseline characteristics of patients were retrieved from cardiac surgery database (cascade, Lahore) of RIC. For all patients who underwent open heart surgery and had age above 75 years. Operative mortality, neurological outcome, low cardiac output state(LCOS), peri-operative myocardial infarction, postop.erative atrial fibrillation (POAF), acute kidney injury (AKI), chest reopening, ICU stay, hospital stay and 1-year survival etc. Are analyzed from retrieved data. Results: Operative mortality is 5.71%, type II neurological deficit is 16.42% and POAF is 25%. Incidence of peri-operative mi, lcos, aki and chest reopening etc is low along with acceptable ICU stay and hospital stay durations. 1-years survival is 95.46%. Conclusion: open heart surgery can be offered to patients with age above 75 years with low operative mortality and morbidity except with relatively higher incidence of type ii neurological deficit and POAF. 1- years survival is impressive with figures of 95.46%.
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Siddiqui et al. (2020) conducted a cohort in Coronary artery disease and other cardiac conditions requiring open heart surgery (n=140). Open heart surgery was evaluated on Operative mortality. Open heart surgery in patients over 75 years of age was associated with a 5.71% operative mortality and a 95.46% 1-year survival rate, alongside a 16.42% incidence of type II neurological deficit.
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