Key result
Octogenarian age linked to ~41% higher mortality after CABG compared to septuagenarians.
Why the study?
Increasing life expectancy makes cardiac surgery in octogenarians common, but the impact of gender on outcomes after CABG in this age group is unclear.
Does octogenarian age increase mortality and complications compared to septuagenarian age in patients undergoing CABG?
Cohort (n=67,568)
Yes
Does octogenarian age increase mortality and complications compared to septuagenarian age in patients undergoing CABG?
Odds Ratio: 1.41 (95% CI 1.36–1.61)
p-value: p=<0.001
Supports equivalent perioperative risk by gender in octogenarians; hypothesis-generating and requires prospective confirmation before practice implications.
Background Increasing life expectancy makes cardiac surgery in octogenarians not very uncommon. In this study, the impact of gender on outcome of octogenarians after coronary artery bypass grafting (CABG) was assessed. Materials and Methods We retrospectively studied 485 octogenarians (176 females: mean age 82.4 ± 2.2 years vs. 306 males: mean age 82.2 ± 2.4 years) who underwent isolated CABG using extracorporeal circulation between January 2005 and December 2012. Results No significant differences were noted between both gender groups with regard to preoperative risk factors. At baseline, the groups differed significantly with respect to mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) (women: 22.3 ± 17.4% vs. men: 17.5 ± 13.3%; p < 0.001). Likewise, EuroSCORE II differs significantly between women and men in our cohort (women: 16.7 ± 11.9% vs. men: 13.9 ± 10.7%; p = 0.008). Intraoperatively, the number of distal anastomoses (3.1 ± 0.9 vs. 3.2 ± 0.8), the mean extracorporeal circulation time (99 ± 31 vs. 102 ± 29 minutes), and the mean aortic cross-clamp time (63 ± 31 vs. 60 ± 19 minutes) were similar in both groups. Postoperatively, no significant differences in complications and major morbidity were observed between the groups. The 30-day mortality (women 8.0 vs. men 9.7%; p = 0.62) were without statistical significance between the groups. Conclusion Outcome of octogenarians after CABG resulted in acceptable mortality. Female gender was not associated with increased risks for morbidity and mortality after surgery. Satisfactory outcomes encourage the offering of surgery in octogenarians.
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Panholzer et al. (2016) conducted a cohort in Coronary artery disease requiring CABG (n=67,568). Octogenarian age (80-89 years) vs. Septuagenarian age (70-79 years) was evaluated on Mortality (OR 1.41, 95% CI 1.36-1.61, p=<0.001). Octogenarian age was associated with significantly higher mortality compared to septuagenarian age in patients undergoing coronary artery bypass grafting (OR 1.41, 95% CI 1.36-1.61, p<0.001).
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