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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2008 June;21(3):139-42
Predictors of mortality in elderly patients undergoing coronary revascularization
Lafci B., Özsöyler I., Kestelli M., Yilik L., Bozok S¸., Yas¸a H., Karahan N., Gürbüz A.
Department of Cardiovascular Surgery Atatürk Education and Research Hospital, Izmir, Turkey
Aim. There has been an increase in the number of elderly patients considered for cardiac surgery. The purpose of this study was to identify determinants of operative mortality of the patients who were in 70 years of age and older.
Methods. One hundred forty-six patients over 70 years of age underwent isolated coronary artery bypass grafting. There were 105 men (71.9%) and 41 women (28.1%). Mean age was 74 years (range; 70 to 86 years). Preoperatively 42 patients (28.8%) had unstable angina pectoris, 27 (18.4%) had chronic obstructive pulmonary disease, 14 (9.6%) had renal dysfunction, and 103 (70%) patients were in New York Heart Association functional class III or IV.
Results. The overall mortality was 8.9% (13/146). Mortality predictors of the patients over 70 years of age and older were female gender, preoperative renal dysfunction, preoperative chronic obstructive pulmonary disease, unstable angina pectoris, and low functional capacity.
Conclusion. Surgical intervention had become inevitable for the elderly patients due to unresponsiveness of the NHYA class III and IV symptoms to medical treatment. We are in the opinion that, careful preoperative evaluation and supportive medication and avoidance of CPB will decrease the operative morbidity and mortality.