Impact of coronary artery bypass grafting in elderly patients

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Aikawa, Priscila
Sartori Cintra, Angelica Rossi
Leite, Cleber Aparecido [UNIFESP]
Marques, Ricardo Henrique
Mackmillan da Silva, Claudio Tafarel
Afonso, Max dos Santos
Paulitsch, Felipe da Silva
Oss, Evandro Augusto
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Objective: To analyze the results of isolated on-pump coronary artery bypass graft surgery (CABG) in patients >= 65 years-old.Methods: Patients undergoing isolated on-pump CABG from December 1st 2010 to July 31th 2012 were divided in two groups: GE (elderly >= 65 years-old, n=103) and GA (adults < 65 years-old, n=150). Preoperative data, intraoperative (as cardiopulmonar bypass time, aortic clamping time, time length of stay in mechanical ventilation - MV - and number of grafts), and postoperative variable (as morbidity, mortality and time length of stay in hospital) were analyzed during hospitalization.Results: in GE, the morbidity rate was greater than in GA (30% vs. 14%, P=0.004), but there was no difference in the mortality rate (5.8% vs. 2.0%, P=0.165). in GA, there was higher prevalence DM (39.6% vs. 27%, P=0.043) and smoking (32.2% versus 19.8%, P=0.042); and in GE, higher prevalence of stroke (17% vs. 6.7%, P=0.013). There was no difference between the groups regarding intraoperative variables. After multivariate analysis, age >= 65-year-old was associated with greater morbidity, but it was not independent predictive factor for in-hospital mortality. Considering in-hospital mortality, stay in ward time length (P=0.006), cardiac (P=0.011) and respiratory complications (P=0.026) were independent predictive factors.Conclusion: This study suggests that patients >= 65-yearold were at increased risk of postoperative complications when submitted to isolated on-pump CABG in comparison to patients < 65-year-old, but not under increased risk of death.
Revista Brasileira de Cirurgia Cardiovascular. São Paulo, SP: Soc Brasil Cirurgia Cardiovasc, v. 28, n. 1, p. 22-28, 2013.