TITLE

Outcomes in octogenarians undergoing coronary artery bypass grafting

AUTHOR(S)
Baskett, Roger; Buth, Karen; Ghali, William; Norris, Colleen; Maas, Tony; Maitland, Andrew; Ross, David; Forgie, Rand; Hirsch, Gregory
PUB. DATE
April 2005
SOURCE
CMAJ: Canadian Medical Association Journal;4/26/2005, Vol. 172 Issue 9, p1183
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Although octogenarians are being referred for coronary artery bypass grafting (CABG) with increasing frequency, contemporary outcomes have not been well described. We examined data from 4 Canadian centres to determine outcomes of CABG in this age group. Methods: Data for the years 1996 to 2001 were examined in a comparison of octogenarians with patients less than 80 years of age. Logistic regression analysis was used to adjust for pre-operative factors and to generate adjusted rates of mortality and postoperative stroke. Results: A total of 15 070 consecutive patients underwent isolated CABG during the study period. Overall, 725 (4.8%) were 80 years of age or older, the proportion increasing from 3.8% in 1996 to 6.2% in 2001 ( p for linear trend = 0.03). The crude rate of death was higher among the octogenarians (9.2% v. 3.8%; p < 0.001), as was the rate of stroke (4.7% v. 1.6%, p < 0.001). The octogenarians had a significantly greater burden of comorbid conditions and more urgent presentation at surgery. After adjustment, the octogenarians remained at greater risk for in-hospital death (odds ratio [OR] 2.64, 95% confidence interval [CI] 1.95-3.57) and stroke (OR 3.25, 95% CI 2.15-4.93). Mortality declined over time for both age groups ( p for linear trend < 0.001 for both groups), but the incidence of postoperative stroke did not change ( p for linear trend = 0.61 [age < 80 years] and 0.08 [age ≥ 80 years]). Octogenarians who underwent elective surgery had crude and adjusted rates of death (OR 1.31, 95% CI 0.60-2.90) and stroke (OR 1.59, 95% CI 0.57-4.44) that were higher than but not significantly different from those for non-octogenarians who underwent elective surgery. Interpretation: In this study, rates of death and stroke were higher among octogenarians, although the adjusted differences in mortality over time were decreasing. The rate of adverse outcomes in association with elective surgery was similar for older and younger...
ACCESSION #
16748335

 

Related Articles

  • Adverse Cerebral Outcomes after Coronary Bypass Surgery. Roach, Gary W.; Kanchuger, Marc; Mangano, Christina Mora; Newman, Mark; Nussmeier, Nancy; Wolman, Richard; Aggarwal, Anil; Marschall, Katherine; Graham, Steven H.; Ley, Catherine; Ozanne, Gerard; Mangano, Dennis T.; Herskowitz, Ahvie; Katseva, Vera; Sears, Rita // New England Journal of Medicine;12/19/96, Vol. 335 Issue 25, p1857 

    Background: Acute changes in cerebral function after elective coronary bypass surgery are a difficult clinical problem. We carried out a multicenter study to determine the incidence and predictors of — and the use of resources associated with — perioperative adverse neurologic...

  • You'd better shop around to fix your heart.  // Executive Report;May94, Vol. 12 Issue 9, p8 

    Presents information on the reports released by the Pennsylvania Health Care Cost Containment Council which reveals the mortality rates and the charges at 35 Pennsylvania hospitals for coronary artery bypass surgery. Purpose of the report; Hospitals with the lowest and the highest average...

  • Admission Plasma Glucose. Zindrou, Dlear; Taylor, Kenneth M.; Bagger, Jens Peder // Diabetes Care;Sep2001, Vol. 24 Issue 9, p1634 

    Presents a study which investigated the relationship between admission plasma glucose and mortality after coronary artery bypass grafting in nondiabetic patients. Details on the operation procedure; Clinical characteristics of the patients studied; Predictors of mortality in nondiabetic...

  • Lowering the death rate after bypass surgery.  // Physician & Sportsmedicine;May96, Vol. 24 Issue 5, p62I 

    States the physicians who perform coronary artery bypass graft (CABG) surgery, then exchange information with each other are likely to see fewer death among their patients. Information on a regional intervention study; Lower mortality rates due to intervention programs; Detailed information in...

  • Influence of Type 2 Diabetes on Functional and Structural Properties of Coronary Artery Bypass Conduits. Lorusso, Roberto; Pentiricci, Samuele; Raddino, Riccardo; Scarabelli, Tiziano M.; Zambelli, Claudia; Villanacci, Vincenzo; Burattin, Anna; Romanelli, Giuseppe; Giustina, Andrea; Casari, Salvatore; Scelsi, Roberto // Diabetes;Nov2003, Vol. 52 Issue 11, p2814 

    Recent studies have reported a high incidence of postoperative unfavorable cardiac-related events in patients with diabetes who underwent coronary artery bypass grafting (CABG). Structural and functional characteristics of CABG conduits, which have been shown to play an important role in patient...

  • QUALITY WATCH. Montague, Jim; Pitman, Hilarie // H&HN: Hospitals & Health Networks;3/20/96, Vol. 70 Issue 6, p14 

    Presents news updates related to surgeries for cerebrovascular and cardiovascular diseases in the United States for March 1996. Possible dangers of the two experimental techniques, carotid angioplasty and stenting, used in the prevention of invasive strokes; Lower mortality of coronary bypass...

  • Stroke Rate of Off-pump Coronary Artery Bypass; Aortocoronary Bypass Versus in-Situ Bypass. Hirose, Hitoshi; Amano, Atushi // Angiology;Nov/Dec2003, Vol. 54 Issue 6, p647 

    Off-pump coronary artery bypass (OPCAB) using in-situ grafts does not require aortic manipulation, and it is theoretically free from the risk of stroke. Because of the limited availability of in-situ grafts, aortocoronary bypass has been conducted in addition to in-situ grafting. In this paper,...

  • Quantum Sufficit.  // American Family Physician;5/15/2002, Vol. 65 Issue 10, p1987 

    Discusses various health-related issues in the U.S. Benefits from moderate exercise; Ways to lower risk of having fatal stroke; Gender difference in the risk of dying in hospital after coronary artery bypass graft surgery.

  • New studies.  // MLO: Medical Laboratory Observer;Apr2001, Vol. 33 Issue 4, p6 

    Provides updates on three medical studies, as of April 2001. Link between coronary-artery bypass grafting and long-term memory loss; Estimated number of U.S. residents who suffer silent strokes every year; Efficacy of a test for human papillomavirus as follow-up for abnormal Pap test result.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics