Is age an independent determinant of mortality in cardiac surgery assuggested by the EuroSCORE?

被引：22
作者：
Mortasawi A. [1 ]
Arnrich B. [2 ]
Rosendahl U. [1 ]
Frerichs I. [3 ]
Albert A. [1 ]
Walter J. [2 ]
Ennker J. [1 ]
机构：
[1] Clin. of Thorac./Cardiovasc. Surg., Heart Institute Lahr/Baden, Lahr
[2] Department of Neuroinformatics, University of Bielefeld, Bielefeld
[3] Dept. of Anaesthesiological Research, University of Göttingen, Göttingen
来源：
BMC Surgery | / 2卷 / 1期
关键词：
Age; cardiac surgery; EuroSCORE; mortality; morbidity;
D O I：
10.1186/1471-2482-2-8
中图分类号：
学科分类号：
摘要：
Background: The proportion of older patients in cardiac surgery is continuously increasing. 37% of patients undergoing heart surgery in Germany in the year 2000 were 70 years of age and older. We have studied the role of age as a determinant of mortality in cardiac surgery in our institutional patient population. Methods: We have calculated the EuroSCORE and the corresponding age-adjusted EuroSCORE in 8769 patients who underwent heart surgery between January 1996 and January 2002 and collected the information on the occurrence of postoperative complications and 30-days mortality. Results: The multimorbidity increased with ascending age. Both the EuroSCORE and the age-adjusted EuroSCORE values increased significantly with age in the whole group of patients as well as in the group of patients who were alive 30 days after heart surgery. The incidence of postoperative complications and 30-days mortality increased significantly with age. In patients who died within 30 days after surgery, the EuroSCORE increased significantly with age, whereas the age-adjusted EuroSCORE did not. The occurrence of diabetes mellitus, arterial hypertension and atrial fibrillation, i.e., the risk factors not considered by the EuroSCORE, exhibited a significant age dependence in our patients. The univariate analysis identified the significant dependence of 30-days mortality on diabetes and atrial fibrillation. The stepwise logistic regression analysis showed the dependence of mortality on diabetes. Conclusions: On the background of the well-known age-dependent structural and functional changes of different body organs, our data show that age is a significant risk indicator in cardiac surgery, strongly correlating with morbidity and mortality. Consequently, special preventive and therapeutic measures are required in clinical environment in the case of elderly patients undergoing cardiac surgery.
引用
收藏
页码：1 / 8
页数：7
相关论文
共 27 条
  • [1] Kalmar P., Irrgang E., Cardiac surgery in the Federal Republic of Germany during 1989. A report by the German Society for Thoracic and Cardiovascular Surgery, Thorac Cardiovasc Surg, 38, pp. 198-200, (1990)
  • [2] Kalmar P., Irrgang E., Cardiac surgery in Germany during 2000. A report by the German Society for Thoracic and Cardiovascular Surgery, Thorac Cardiovasc Surg, 48, (2001)
  • [3] Geissler H.J., Holzl P., Marohl S., Kuhn-Regnier F., Mehlhorn U., Sudkamp M., De Vivie E.R., Risk stratification in heart surgery: Comparison of six score systems, Eur J Cardiothorac Surg, 17, pp. 400-406, (2000)
  • [4] Nashef S.A.M., Roques F., Michel P., Gauducheau E., Lemeshow S., Salamon R., European system for cardiac operative risk evaluation (EuroSCORE), Eur J Cardiothorac Surg, 16, pp. 9-13, (1999)
  • [5] Roques F., Nashef S.A.M., Michel P., Gauducheau E., De Vinvetiis C., Baudet E., Cortina J., David M., Faichney A., Gabrielle F., Gams E., Harjula A., Totnes M.T., Pinna Pintor P., Salamon R., Thulin L., Risk factors and outcome in European cardiac surgery: Analysis of the EuroSCORE multinational database of 19030 patients, Eur J Cardiothoracic Surg, 15, pp. 816-823, (1999)
  • [6] Alexander K.P., Anstrom K.J., Muhlbaier L.H., Grosswald R.D., Smith P.K., Jones R.H., Peterson E.D., Outcomes of cardiac surgery in patients age 3 80 years: Results from the National Cardiovascular Network, J Am Coll Cardiol, 35, pp. 731-738, (2000)
  • [7] Craver J.M., Puskas J.D., Weintraub W.W., Shen Y., Guyton R.A., Gott J.P., Jones E.L., 601 Octogenarians undergoing cardiac surgery: Outcome and comparison with younger age groups, Ann Thorac Surg, 67, pp. 1104-1110, (1999)
  • [8] Fruitman D.S., MacDougall C.E., Ross D.B., Cardiac surgery in octogenarians: Can elderly patients benefit? Quality of life after cardiac surgery, Ann Thorac Surg, 68, pp. 2129-2135, (1999)
  • [9] Avery G.J., Ley S.J., Hill J.D., Hershon J.J., Dick S.E., Cardiac surgery in the octogenarian: Evaluation of risk, cost, and outcome, Ann Thorac Surg, 71, pp. 591-596, (2001)
  • [10] Kitzman D.W., Why is diastolic heart failure in older patients the cardiologist's enigma?, Dialogues in Cardiovascular Medicine, 6, pp. 95-103, (2001)
123