Heart surgery can be safe for octogenarians

Cardiac surgery can be safely performed in octogenarians and may improve their life expectancy, according to a report in an online issue of the medical journal Heart. These findings are the latest to suggest that old age, per se, should not be a barrier to cardiac surgery.

Dr. Samer Nashef, from Papworth Hospital in Cambridge, UK, and colleagues assessed the outcomes of 12,461 consecutive patients who underwent cardiac surgery at a regional center between 1996 and 2003. Of these subjects, 706 were older than 80 years of age.

Compared with their younger peers, conditions that were more common in octogenarians included impaired function of the ventricle, unstable angina and the need for valve surgery. In addition, the octogenarian group contained more female patients.

By contrast, younger patients were more likely to have had previous heart surgery, a previous Heart Attack and Diabetes, the report indicates.

The hospital mortality rates for all patients and for octogenarians only were 3.9 percent and 9.8 percent, respectively. Both of these values were significantly lower than what was predicted using a standardized risk stratification system.

The percentage of octogenarians who had an intensive care unit stay longer than 24 hours was 37 percent, significantly higher than the 23 percent observed for younger patients.

The 5-year survival rate for surgery-treated octogenarians was 82.1 percent, while the rate for their age- and sex-matched peers in the general population was 55.9 percent

"This is the largest UK single-center experience and the largest risk-stratified, comparative study in the world examining long-term outcomes of cardiac surgery in the elderly," the authors note. "It confirms that cardiac surgery in selected octogenarians can be performed with good results."

SOURCE: Heart, August 18, 2005.