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Chirurgie 1. Dezember 2011

There is no significant difference in the operative risk between octogenarians compared with patients younger than 60 years in cardiac surgery*

BACKGROUND: The constantly increasing life-expectancy has led to a high incidence of severe heart diseases in elderly people. The aim of this study was to compare the 30-day morbidity and mortality of octogenarians (group I) with a cohort younger than 60 years (group II). METHODS: Both groups (July 2008 and July 2011) were extracted from the Cardiac database. Demographic data, risk factors, surgical procedures and complications were double-checked. To compare the proportions of patients, Fisher's exact test was performed. RESULTS: In group I (n = 348 patients, 82.6±2.6 years) elective cases (35.3% valvular procedures) were performed in 77.6% and in 67.9% in group II (n = 656 patients, 50±2.4 years). The ICU-stay was 86±108 h (10–1040 h) (median: 51 h) in group I versus 94±256 h (3–4700 h) (median: 46 h). Postoperative renal failure occured in 2.9% in group I. After 17.9 h (1–760 h) (median 4.5 h) patients in group I could be weaned from ventiulation (group II: 26.4 h [1–1230 h] [median 4 h]). The need for blood transfusion was 1.7 units (0–10) in group I (1 unit (0–28) in group II). The 30-day mortality was 5.5% (n = 19) in group I versus 4.7 (n = 31) in group II and was in both groups lower than the expected EuroScore mortality of 16.1 and 6.25%. CONCLUSIONS: It must be argued that the surgical outcome of elderly patients is much better than the individual feeling in the daily routine. We proved that octogenarians should not be excluded from possible benefits of cardiac surgery. As a result of comparing postoperative data of the two different groups we cannot attribute higher costs for our elderly patients.

H. Mächler, L. Salaymeh, B. Zirngast, M. Anelli-Monti, P. Oberwalder, A. Yates, I. Knez, St. Huber, Ch. Streinu, I. Ovcina, D. Malliga, I. Keeling, E. Beran, A. Mircic, K. Meszaros, R. Hetterle, K. Rieger, P. Curcic, A. Vötsch, W. Marte, W. Toller, F. Quehenberger, D. Dacar, European Surgery 6/2011

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