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CURRENT ISSUEMINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036

Frequency: Monthly

ISSN 0375-9393

Online ISSN 1827-1596

 

Minerva Anestesiologica 2004 October;70(10):717-26

ANESTHESIOLOGY 

    ORIGINAL ARTICLES

Low perioperative mortality for cardiac surgery in octogenarians

Zangrillo A. 1, Sparicio D. 1, Crivellari M. 1, Aletti G. 2, Bove T. 1, Mamo D. 1, Bignami E. 1, Marino G. 1, Landoni G. 1

1 Department of Cardiovascular Anesthesia IRCCS San Raffaele Hospital “Vita-Salute” University, Milan, Italy
2 Department of Mathematics University of Milan, Milan, Italy

Aim. The num­ber of car­diac oper­a­tions in octo­ge­nar­ians is stead­i­ly increas­ing. A ­review of per­son­al 4 ­years’ expe­ri­ence is ­made in ­order to iden­ti­fy ­which var­i­ables are asso­ciat­ed to a ­poor prog­no­sis in ­this ­high ­risk pop­u­la­tion.
Methods. Perioperative var­i­ables and ­short-­term out­come of 109 con­sec­u­tive octo­ge­nar­ians ­were pros­pec­tive­ly col­lect­ed in a data­base. Data ­were ana­lysed ­with descrip­tive sta­tis­tics. Univariate and mul­ti­var­i­ate anal­y­ses ­were per­formed to iden­ti­fy pre­op­er­a­tive ­risk fac­tors for pro­longed mechan­i­cal ven­ti­la­tion and ICU ­stay.
Results. The 109 octo­ge­nar­ians rep­re­sent­ed 1.8% of the 4 940 car­diac oper­a­tions per­formed at our University Teaching Hospital in the peri­od January 1998 - June 2001: 94 ­patients had comor­bid­ities (86%); 46 under­went ­valve sur­gery (42%), 38 had cor­o­nary ­artery ­bypass graft­ing sur­gery (36%), and com­bined pro­ce­dures or aor­tic ­arch replace­ment ­were per­formed in 25 ­patients (22%). Two ­patients ­died (1.8%). Post­op­er­a­tive com­pli­ca­tions includ­ed: myo­car­dial infarc­tion (10 ­patients, 9%), ­stroke (6 ­patients, 5%), ­renal replace­ment ther­a­py (1 ­patient, 1%). Sixty ­nine ­patients (63%) had an unevent­ful per­i­op­er­a­tive peri­od (63%). On a mul­ti­var­i­ate anal­y­sis, car­di­o­pul­mo­nary ­bypass (CPB) ­time was asso­ciat­ed ­with pro­longed intu­ba­tion and ICU ­stay; ­mitral pathol­o­gy pre­dict­ed pro­longed intu­ba­tion ­while pre­vi­ous car­diac sur­gery was asso­ciat­ed ­with pro­longed ICU ­stay.
Conclusion. The 109 octo­ge­nar­ians stud­ied had an excel­lent ­course in the imme­di­ate post­op­er­a­tive peri­od. Therefore, on the ­basis of per­son­al expe­ri­ence car­diac sur­gery ­could be safe­ly per­formed in octo­ge­nar­ians

language: English, Italian


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