Research Article
BibTex RIS Cite

Coronary Bypass in Patients Aged Seventy Years and Over: The Risk Factors Affecting Morbidity and Mortality

Year 2023, Volume: 76 Issue: 3, 227 - 233, 30.06.2024

Abstract

Objectives: The increase in the number of coronary artery bypass graft (CABG) surgery in the elderly patients necessitates clinicans to make a rational decision considering the balance of risk and benefit. The aim of this study was to evaluate the risk factors affecting morbidity and mortality of CABG surgery in patients aged 70 years and over.

Materials and Methods: Patients aged 70 years and older who had isolated coronary artery disease (CAD) and underwent isolated CABG surgery between January 2006 and December 2015, were included in the study. Patients who need urgent surgery, had history of cardiovascular surgery and/ or had intervention to cardiac valves or aorta and opening of heart chambers during surgery due to other that cannulation and under age of 70 were excluded from the study. The demographic characteristics, preoperative, intraoperative and postoperative variables of the patients were examined retrospectively. The statistical analyses were performed in SPSS 15.0 program and p<0.05 was considered as statistically significant.

Results: Total 349 patients were included in study, survival analysis was conducted in 312 (89.4%) patients. In-hospital mortality was 8.9%. Chronic obstructive pulmonary disease, history of cerebrovascular disease, history of myocardial infarction, class III-IV functional capacity of New York Heart
Association and older age were found to be related with increased ventilation time and re-entubation. Age, diabetes mellitus, chronic obstructive pulmonary disease, carotis artery stenosis, class III-IV functional capacity of New York Heart Association, high preoperative glomerular filtration rate and use of left internal mammarian artery graft were found to be statistically significant in terms of increased postoperative mortality.

Conclusion: This study demonstrates that CABG surgery in 70 age and older patients for treatment of CAD have a reasonable morbidity and
mortality.

Project Number

-

References

  • 1. World Health Organization. Fact sheet N°317. 2015. https://www.who.int/ news-room/fact-sheets
  • 2. Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997;349:1436-1442.
  • 3. Ölüm Nedeni İstatistikleri, Türkiye İstatistik Kurumu. 2014. https://data.tuik. gov.tr/Bulten/Index?p=Olum-Nedeni-Istatistikleri-2014-18855
  • 4. Kinsella K, Wan H. International population reports. An Aging World: 2008. https://www.census.gov/library/publications/2009/demo/p95-09-1.html
  • 5. Paparella D, Yau TM, Young E. Cardiopulmonary bypass induced inflammation: pathophysiology and treatment. An update. Eur J Cardiothorac Surg. 2002;21:232-244.
  • 6. Hedeshian MH, Namour N, Dziadik E, et al. Does increasing age have a negative impact on six-month functional outcome after coronary arterybypass? Surgery. 2002;132:239-244.
  • 7. Naylor CD, Ugnat AM, Weinkauf D, et al. Coronary artery bypass grafting in Canada: What is its rate of use? Which rate is right? CMAJ. 1992;146:851- 859.
  • 8. Yanagawa B, Puskas JD, Verma S, et al. Coronary Artery Bypass Graft Should Be Considered in Octogenarians With Multivessel Coronary Disease. Can JCardiol. 2016;32:1045.e1-1045.e3.
  • 9. Tsai TP, Nessim S, Kass RM, et al. Morbidity and mortality after coronary artery bypass in octogenarians. Ann Thorac Surg. 1991;51:983-986.
  • 10. Merrill WH, Stewart JR, Frist WH, et al. Cardiac surgery in patients age 80 years or older. Ann Surg. 1990;211:772-775.
  • 11. Pawlaczyk R, Swietlik D, Lango R, et al. Off-pump coronary surgery mayreduce stroke, respiratory failure, and mortality in octogenarians. Ann Thorac Surg. 2012;94:29-37.
  • 12. Sun L, Zhou M, Ji Y, et al. Off-pump versus on-pump coronary artery bypassgrafting for octogenarians: A meta-analysis involving 146 372 patients. Clin Cardiol. 2022;45:331-341.
  • 13. Ozen A, Unal EU, Songur M, et al. Coronary artery bypass grafting in the octogenarians: should we intervene, or leave them be? J Geriatr Cardiol. 2015;12:147-152.
  • 14. Peterson ED, Cowper PA, Jollis JG, et al. Outcomes of coronary artery bypass graft surgery in 24,461 patients aged 80 years or older. Circulation. 1995;92(9 Suppl):II85-II91.
  • 15. Alexander KP, Anstrom KJ, Muhlbaier LH, et al. Outcomes of cardiac surgery in patients > or = 80 years: results from the National Cardiovascular Network. J Am Coll Cardiol. 2000;35:731-738.
  • 16. Ho CH, Chen YC, Chu CC, et al. Postoperative Complications After Coronary Artery Bypass Grafting in Patients With Chronic Obstructive Pulmonary Disease. Medicine (Baltimore). 2016;95:e2926.
  • 17. Safaie N, Montazerghaem H, Jodati A, et al. In-Hospital Complications of Coronary Artery Bypass Graft Surgery in Patients Older Than 70 Years. J Cardiovasc Thorac Res. 2015;7:60-62.
  • 18. Hirose H, Amano A, Takahashi A. Coronary artery bypass grafting for octogenarians: experience in a private hospital and review of the literature. Ann Thorac Cardiovasc Surg. 2001;7:282-291.

Sarıcaoğlu ve Uysalel. Yetmiş Yaş Üzeri Hastalarda Koroner Bypass

Year 2023, Volume: 76 Issue: 3, 227 - 233, 30.06.2024

Abstract

Ethical Statement

Etik Kurul Onayı: Bu çalışma Ankara Üniversitesi Tıp Fakültesi, İnsan Araştırmaları Etik Kurulu tarafından onaylandı (karar no: İ07-521-23, tarih: 29.08.2023). Hasta Onayı: Hastalar ile ilgili bilgilere retrospektif olarak hastane bilgi sistemi aracılığıyla ulaşılmıştır. Hakem Değerlendirmesi: Editörler kurulunun dışından olan kişiler tarafından değerlendirilmiştir.

Supporting Institution

-

Project Number

-

Thanks

-

References

  • 1. World Health Organization. Fact sheet N°317. 2015. https://www.who.int/ news-room/fact-sheets
  • 2. Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997;349:1436-1442.
  • 3. Ölüm Nedeni İstatistikleri, Türkiye İstatistik Kurumu. 2014. https://data.tuik. gov.tr/Bulten/Index?p=Olum-Nedeni-Istatistikleri-2014-18855
  • 4. Kinsella K, Wan H. International population reports. An Aging World: 2008. https://www.census.gov/library/publications/2009/demo/p95-09-1.html
  • 5. Paparella D, Yau TM, Young E. Cardiopulmonary bypass induced inflammation: pathophysiology and treatment. An update. Eur J Cardiothorac Surg. 2002;21:232-244.
  • 6. Hedeshian MH, Namour N, Dziadik E, et al. Does increasing age have a negative impact on six-month functional outcome after coronary arterybypass? Surgery. 2002;132:239-244.
  • 7. Naylor CD, Ugnat AM, Weinkauf D, et al. Coronary artery bypass grafting in Canada: What is its rate of use? Which rate is right? CMAJ. 1992;146:851- 859.
  • 8. Yanagawa B, Puskas JD, Verma S, et al. Coronary Artery Bypass Graft Should Be Considered in Octogenarians With Multivessel Coronary Disease. Can JCardiol. 2016;32:1045.e1-1045.e3.
  • 9. Tsai TP, Nessim S, Kass RM, et al. Morbidity and mortality after coronary artery bypass in octogenarians. Ann Thorac Surg. 1991;51:983-986.
  • 10. Merrill WH, Stewart JR, Frist WH, et al. Cardiac surgery in patients age 80 years or older. Ann Surg. 1990;211:772-775.
  • 11. Pawlaczyk R, Swietlik D, Lango R, et al. Off-pump coronary surgery mayreduce stroke, respiratory failure, and mortality in octogenarians. Ann Thorac Surg. 2012;94:29-37.
  • 12. Sun L, Zhou M, Ji Y, et al. Off-pump versus on-pump coronary artery bypassgrafting for octogenarians: A meta-analysis involving 146 372 patients. Clin Cardiol. 2022;45:331-341.
  • 13. Ozen A, Unal EU, Songur M, et al. Coronary artery bypass grafting in the octogenarians: should we intervene, or leave them be? J Geriatr Cardiol. 2015;12:147-152.
  • 14. Peterson ED, Cowper PA, Jollis JG, et al. Outcomes of coronary artery bypass graft surgery in 24,461 patients aged 80 years or older. Circulation. 1995;92(9 Suppl):II85-II91.
  • 15. Alexander KP, Anstrom KJ, Muhlbaier LH, et al. Outcomes of cardiac surgery in patients > or = 80 years: results from the National Cardiovascular Network. J Am Coll Cardiol. 2000;35:731-738.
  • 16. Ho CH, Chen YC, Chu CC, et al. Postoperative Complications After Coronary Artery Bypass Grafting in Patients With Chronic Obstructive Pulmonary Disease. Medicine (Baltimore). 2016;95:e2926.
  • 17. Safaie N, Montazerghaem H, Jodati A, et al. In-Hospital Complications of Coronary Artery Bypass Graft Surgery in Patients Older Than 70 Years. J Cardiovasc Thorac Res. 2015;7:60-62.
  • 18. Hirose H, Amano A, Takahashi A. Coronary artery bypass grafting for octogenarians: experience in a private hospital and review of the literature. Ann Thorac Cardiovasc Surg. 2001;7:282-291.
There are 18 citations in total.

Details

Primary Language English
Subjects Cardiovascular Surgery
Journal Section Research Article
Authors

Mehme Cahit Sarıcaoğlu 0000-0002-0378-8855

Mustafa Adnan Uysalel This is me 0000-0001-5395-7111

Project Number -
Publication Date June 30, 2024
Published in Issue Year 2023 Volume: 76 Issue: 3

Cite

APA Sarıcaoğlu, M. C., & Uysalel, M. A. (2024). Coronary Bypass in Patients Aged Seventy Years and Over: The Risk Factors Affecting Morbidity and Mortality. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 76(3), 227-233. https://doi.org/10.4274/atfm.galenos.2023.82712
AMA Sarıcaoğlu MC, Uysalel MA. Coronary Bypass in Patients Aged Seventy Years and Over: The Risk Factors Affecting Morbidity and Mortality. Ankara Üniversitesi Tıp Fakültesi Mecmuası. June 2024;76(3):227-233. doi:10.4274/atfm.galenos.2023.82712
Chicago Sarıcaoğlu, Mehme Cahit, and Mustafa Adnan Uysalel. “Coronary Bypass in Patients Aged Seventy Years and Over: The Risk Factors Affecting Morbidity and Mortality”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 76, no. 3 (June 2024): 227-33. https://doi.org/10.4274/atfm.galenos.2023.82712.
EndNote Sarıcaoğlu MC, Uysalel MA (June 1, 2024) Coronary Bypass in Patients Aged Seventy Years and Over: The Risk Factors Affecting Morbidity and Mortality. Ankara Üniversitesi Tıp Fakültesi Mecmuası 76 3 227–233.
IEEE M. C. Sarıcaoğlu and M. A. Uysalel, “Coronary Bypass in Patients Aged Seventy Years and Over: The Risk Factors Affecting Morbidity and Mortality”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 76, no. 3, pp. 227–233, 2024, doi: 10.4274/atfm.galenos.2023.82712.
ISNAD Sarıcaoğlu, Mehme Cahit - Uysalel, Mustafa Adnan. “Coronary Bypass in Patients Aged Seventy Years and Over: The Risk Factors Affecting Morbidity and Mortality”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 76/3 (June2024), 227-233. https://doi.org/10.4274/atfm.galenos.2023.82712.
JAMA Sarıcaoğlu MC, Uysalel MA. Coronary Bypass in Patients Aged Seventy Years and Over: The Risk Factors Affecting Morbidity and Mortality. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2024;76:227–233.
MLA Sarıcaoğlu, Mehme Cahit and Mustafa Adnan Uysalel. “Coronary Bypass in Patients Aged Seventy Years and Over: The Risk Factors Affecting Morbidity and Mortality”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 76, no. 3, 2024, pp. 227-33, doi:10.4274/atfm.galenos.2023.82712.
Vancouver Sarıcaoğlu MC, Uysalel MA. Coronary Bypass in Patients Aged Seventy Years and Over: The Risk Factors Affecting Morbidity and Mortality. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2024;76(3):227-33.