Clinical Results and Quality of Life after Nonelective Cardiac Surgery in Octogenarians
Thieme. All rights reserved..
BACKGROUND: We analyzed the short-term and mid-term outcomes as well as the health-related quality of life (HRQOL) of octogenarians undergoing elective and urgent cardiac surgery.
PATIENTS AND METHODS: We retrospectively identified 688 consecutive octogenarians who underwent cardiac surgery at our center between January 2012 and December 2019. A propensity score matching was performed which resulted in the formation of 80 matched pairs. The patients were interviewed and the Short Form-36 survey was used to assess the HRQOL of survivors. Multivariable analysis incorporated binary logistic regression using a forward stepwise (conditional) model.
RESULTS: The median age of the matched cohort was 82 years (p = 0.937), among whom, 38.8% of patients were female (p = 0.196). The median EuroSCORE II of the matched cohort was 19.4% (10.1-39.1%). The duration of postoperative mechanical ventilation was found to be independently associated with in-hospital mortality (odds ratio: 1.01 [95% confidence interval: 1.0-1.02], p = 0.038). The survival rates at 1, 2, and 5 years was 75.0, 72.0, and 46.0%, respectively. There was no difference in the total survival between the groups (p = 0.080). The physical health summary score was 41 (30-51) for the elective patients and 42 (35-49) for the nonelective octogenarians (p = 0.581). The median mental health summary scores were 56 (48-60) and 58 (52-60), respectively (p = 0.351).
CONCLUSION: Cardiac surgery can be performed in octogenarians with good results and survivors enjoy a good quality of life; however, the indication for surgery or especially for escalation of therapy should always be made prudently, reserved, and in consideration of patient expectations.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:70 |
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| Enthalten in: |
The Thoracic and cardiovascular surgeon - 70(2022), 5 vom: 18. Aug., Seite 384-391 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Saha, Shekhar [VerfasserIn] |
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| Anmerkungen: |
Date Completed 12.08.2022 Date Revised 25.08.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1055/s-0041-1730029 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM344673758 |
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| 500 | |a Date Revised 25.08.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Thieme. All rights reserved. | ||
| 520 | |a BACKGROUND: We analyzed the short-term and mid-term outcomes as well as the health-related quality of life (HRQOL) of octogenarians undergoing elective and urgent cardiac surgery | ||
| 520 | |a PATIENTS AND METHODS: We retrospectively identified 688 consecutive octogenarians who underwent cardiac surgery at our center between January 2012 and December 2019. A propensity score matching was performed which resulted in the formation of 80 matched pairs. The patients were interviewed and the Short Form-36 survey was used to assess the HRQOL of survivors. Multivariable analysis incorporated binary logistic regression using a forward stepwise (conditional) model | ||
| 520 | |a RESULTS: The median age of the matched cohort was 82 years (p = 0.937), among whom, 38.8% of patients were female (p = 0.196). The median EuroSCORE II of the matched cohort was 19.4% (10.1-39.1%). The duration of postoperative mechanical ventilation was found to be independently associated with in-hospital mortality (odds ratio: 1.01 [95% confidence interval: 1.0-1.02], p = 0.038). The survival rates at 1, 2, and 5 years was 75.0, 72.0, and 46.0%, respectively. There was no difference in the total survival between the groups (p = 0.080). The physical health summary score was 41 (30-51) for the elective patients and 42 (35-49) for the nonelective octogenarians (p = 0.581). The median mental health summary scores were 56 (48-60) and 58 (52-60), respectively (p = 0.351) | ||
| 520 | |a CONCLUSION: Cardiac surgery can be performed in octogenarians with good results and survivors enjoy a good quality of life; however, the indication for surgery or especially for escalation of therapy should always be made prudently, reserved, and in consideration of patient expectations | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Lang, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a von der Linden, Julia |e verfasserin |4 aut | |
| 700 | 1 | |a Wassilowsky, Dietmar |e verfasserin |4 aut | |
| 700 | 1 | |a Peterss, Sven |e verfasserin |4 aut | |
| 700 | 1 | |a Pichlmaier, Maximilian |e verfasserin |4 aut | |
| 700 | 1 | |a Hagl, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Juchem, Gerd |e verfasserin |4 aut | |
| 700 | 1 | |a Joskowiak, Dominik |e verfasserin |4 aut | |
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