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    Critical analysis of early and late outcomes after isolated coronary artery bypass surgery in elderly patients

    Access Status
    Fulltext not available
    Authors
    Saxena, A.
    Dinh, D.
    Yap, C.
    Reid, Christopher
    Billah, B.
    Smith, J.
    Shardey, G.
    Newcomb, A.
    Date
    2011
    Type
    Journal Article
    
    Metadata
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    Citation
    Saxena, A. and Dinh, D. and Yap, C. and Reid, C. and Billah, B. and Smith, J. and Shardey, G. et al. 2011. Critical analysis of early and late outcomes after isolated coronary artery bypass surgery in elderly patients. Annals of Thoracic Surgery. 92 (5): pp. 1703-1711.
    Source Title
    Annals of Thoracic Surgery
    DOI
    10.1016/j.athoracsur.2011.05.086
    ISSN
    0003-4975
    School
    Department of Health Policy and Management
    URI
    http://hdl.handle.net/20.500.11937/29536
    Collection
    • Curtin Research Publications
    Abstract

    Background: The proportion of elderly (≥80 years) patients undergoing coronary artery bypass surgery (CABG) is increasing. Methods: A retrospective analysis of data, collected by the Australasian Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database Program between June 2001 and December 2009 was performed. Isolated CABG was performed in 21,534 patients; of these, 1,664 (7.7%) were at least 80 years old (group 1). Patient characteristics, morbidity, and short-term mortality of these patients were compared with those aged less than 80 years (group 2). The long-term outcome of group 1 patients after CABG surgery was compared with an age and sex-matched Australian population. Results: Patients over 80 years old were more likely to be female (36.6% vs 17.3%, p < 0.001) and presented significantly more often with heart failure, hypertension, and triple-vessel disease (all p < 0.05). The 30-day mortality was higher in group 1 patients (4.2% vs 1.5%, p < 0.001). Group 1 patients also had an increased risk of complications, including prolonged (>24 hours) ventilation (14.2% vs 8.2%, p < 0.001), renal failure (7.3% vs 3.4%, p < 0.001), and mean intensive care unit stay (60.7 vs 42.5 hours, p < 0.001). The 5-year survival of elderly patients (73%) was comparable with the age-matched Australian population. Independent risk factors for 30-day mortality in group 1 patients included preoperative renal failure (p = 0.010), congestive heart failure (p = 0.014), and a nonelective procedure (p = 0.016). Conclusions: Elderly patients who undergo isolated CABG have significantly lower perioperative risks than have been previously reported. The long-term survival of these patients is comparable with an age-adjusted population.

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    • Comparison of the Safety and Efficacy of On-Pump (ONCAB) versus Off-Pump (OPCAB) Coronary Artery Bypass Graft Surgery in the Elderly: A Review of the ANZSCTS database
      Dhurandhar, V.; Saxena, A.; Parikh, R.; Vallely, M.; Wilson, M.; Butcher, J.; Black, D.; Tran, L.; Reid, Christopher; Bannon, P. (2015)
      Background: The elderly population (age >70 years) incurs greater mortality and morbidity following CABG. OPCAB may mitigate these otucomes. A retrospective analysis of the results of OPCAB in this population was performed. ...
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