Survival outcomes from cardiac surgery in patients aged 80 years and over

Increasingly, octogenarian and older patients are presenting for cardiac surgery. Elderly patients are more likely to have concomitant illness and so may be more likely to die. The aim of this study was to compare the incidence of complications in patients 80 years or older with those younger than 80 years. Data were extracted from the Patient Analysis and Tracking system (PATS) used at Bristol Royal Infirmary Cardiac Surgical Unit between April 1996 and April 2007. Minimum duration for follow up was two years. Of 10 548 cardiac surgical operations, 273 (2.6%) were carried out in patients aged 80 years or older (mean 82 years), before 1 April 2005. Surgery was elective in 141 (51.6%), 109 patients (39.9%) underwent coronary artery bypass grafting, 89 patients (32.6%) underwent valve replacement and 75 patients (27.5%) underwent other or combined procedures. In-hospital mortality for patients aged 80 years and over for coronary artery bypass grafting was 1.8%, for valve surgery 11.2% and combined procedures 13.3%. Actuarial survival, irrespective of procedure, for patients 80 years and over was 92.3% compared to 97.3% for the rest of the adult dataset at 30 days, 88.6% compared to 95.8% at 6 months, 87.5% compared to 95.1% at 1 year and 82.4% compared to 93.4% at 2 years. Previous studies have shown that elderly patients can regain an adequate quality of life and become physically autonomous again after cardiac surgery [1]. The present study indicates that patients aged 80 years and over only have a higher mortality for certain cardiac surgical procedures. However, compared to younger patients, the overall mortality in those aged eighty and over is greater at 30 days, 6 months, 1 year and 2 years.