Determinants of operative mortality in octogenarians undergoing coronary bypass

Donald Williams, Roger Carrillo, Ernest A. Traad, Charles H. Wyatt, Robert Grahowski, S. Howard Wittels, George Ebra

Research output: Contribution to journalArticle

103 Citations (Scopus)

Abstract

Background.: The elderly segment of the population is increasing rapidly, and surgeons are being asked to consider patients more than 80 years old as candidates for coronary bypass. The objective of this study was to identify risk factors that may adversely affect mortality as well as analyze functional outcomes and survival in octogenarians undergoing coronary bypass. Methods.: From July 1989 through February 1994, 300 consecutive patients 80 years of age and older underwent coronary artery bypass grafting. There were 176 men (58.7%) and 124 women (41.3%) with a mean age of 80.9 years (range, 80 to 99 years). Preoperatively, 274 patients (91.3%) had disabling angina, 76 (25.3%) had left main coronary stenosis greater than 50%, and 293 patients (98.3%) were in New York Heart Association class III or IV. Results.: The overall hospital mortality was 11.0% (33/300) with an elective mortality of 9.6% (23/240), urgent mortality of 11% (5/45), and emergent mortality of 33.3% (5/15). Significant independent predictors of operative mortality were preoperative renal dysfunction, postoperative pulmonary insufficiency, postoperative renal dysfunction, use of intraaortic balloon pumping, and sternal wound infection. The actuarial survival for patients discharged from the hospital was 74.6% ± 5.6% (standard error of the mean) at 54 months. Conclusions.: A favorable outcome may be expected when coronary artery bypass grafting is performed in patients 80 years of age or older with severe angina.

Original languageEnglish
Pages (from-to)1038-1043
Number of pages6
JournalThe Annals of Thoracic Surgery
Volume60
Issue number4
DOIs
StatePublished - Jan 1 1995

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Mortality
Coronary Artery Bypass
Intra-Aortic Balloon Pumping
Survival
Coronary Stenosis
Wound Infection
Hospital Mortality
Renal Insufficiency
Kidney
Lung
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Williams, D., Carrillo, R., Traad, E. A., Wyatt, C. H., Grahowski, R., Wittels, S. H., & Ebra, G. (1995). Determinants of operative mortality in octogenarians undergoing coronary bypass. The Annals of Thoracic Surgery, 60(4), 1038-1043. https://doi.org/10.1016/0003-4975(95)00430-S

Determinants of operative mortality in octogenarians undergoing coronary bypass. / Williams, Donald; Carrillo, Roger; Traad, Ernest A.; Wyatt, Charles H.; Grahowski, Robert; Wittels, S. Howard; Ebra, George.

In: The Annals of Thoracic Surgery, Vol. 60, No. 4, 01.01.1995, p. 1038-1043.

Research output: Contribution to journalArticle

Williams, D, Carrillo, R, Traad, EA, Wyatt, CH, Grahowski, R, Wittels, SH & Ebra, G 1995, 'Determinants of operative mortality in octogenarians undergoing coronary bypass', The Annals of Thoracic Surgery, vol. 60, no. 4, pp. 1038-1043. https://doi.org/10.1016/0003-4975(95)00430-S
Williams D, Carrillo R, Traad EA, Wyatt CH, Grahowski R, Wittels SH et al. Determinants of operative mortality in octogenarians undergoing coronary bypass. The Annals of Thoracic Surgery. 1995 Jan 1;60(4):1038-1043. https://doi.org/10.1016/0003-4975(95)00430-S
Williams, Donald ; Carrillo, Roger ; Traad, Ernest A. ; Wyatt, Charles H. ; Grahowski, Robert ; Wittels, S. Howard ; Ebra, George. / Determinants of operative mortality in octogenarians undergoing coronary bypass. In: The Annals of Thoracic Surgery. 1995 ; Vol. 60, No. 4. pp. 1038-1043.
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