Propensity analysis of outcome in coronary artery bypass graft surgery patients >75 years old

被引：10
作者：
Al-Alao B.S. [1 ,2 ]
Parissis H. [2 ]
McGovern E. [1 ]
Tolan M. [1 ]
Young V.K. [1 ]
机构：
[1] Department of Cardiothoracic Surgery, St James's Hospital, Dublin
[2] Department of Cardiothoracic Surgery, Royal Victoria Hospital, Belfast BT12 6BA, Grosvenor Road
来源：
General Thoracic and Cardiovascular Surgery | 2012年 / 60卷 / 4期
关键词：
Cardiac surgery; Elderly; Outcome; Propensity match;
D O I：
10.1007/s11748-011-0875-0
中图分类号：
学科分类号：
摘要：
Purpose. We looked at the complications and hospital resources of an elderly population undergoing first-time isolated coronary artery bypass graft surgery (CABG) in comparison to a younger counterpart for a propensity matched cohort. Methods. A retrospective analysis of prospectively collected data was conducted on 2804 CABG patients. Two age groups, >75 years and <75 years, were generated. Potential differences in demographic, baseline, preoperative, and intraoperative characteristics were investigated. A propensity score based on these differences was calculated and used to create a matched set of patients. Major postoperative complications were recorded, and data on indicators of resource utilization were collected. Results. In all, 311 (11.1%) patients were identifi ed as >75 years of age. The observed complication rate was signifi cantly higher in overall, pulmonary, cardiac, renal, gastrointestinal (GI), neurological, infective, and mortality categories (P < 0.0001). Observed hospital resource utilization was signifi cant in the elderly group in terms of initial stay in the intensive care unit (ICU) and ICU readmission (P < 0.05) and in all preoperative, postoperative, cardiac surgery, and total hospital stays (P < 0.001). However, after propensity matching to 311 patients <75 years, the overall postoperative complication rate maintained its signifi cance (P < 0.0001), in addition to atrial fi brillation and neurological, renal, and GI complications (P < 0.05). Elderly patients required longer duration of ventilation postoperatively and longer postoperative stay, cardiac surgery stay, and total hospital stay; and they maintained a higher surgical mortality rate (6.1% vs. 2.6%) (P < 0.05). Conclusion. Elderly patients undergoing CABG had signifi cantly higher rates of postoperative complications. Their prolonged hospital stay and consequently higher resources utilization need to be adequately highlighted to heath care offi cials and appropriately addressed. © The Japanese Association for Thoracic Surgery 2012.
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页码：217 / 224
页数：7
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