Effect of Age on Postoperative Results in Elderly Coronary By-pass Patients

Yıl 2013, Cilt: 16 Sayı: 3, 189 - 198, 01.03.2012

Adil Polat Funda Gümüş Hüseyin Kuplay Cihan Yücel Serkan Sönmez Seçkin Sarıoğlu Vedat Erentuğ

https://doi.org/10.5578/kkd.5595

Öz

Introduction: The purpose of this study is to analyze the outcome results of coronary by-pass operations from a single institution. The post-operative neurologic complications have been analyzed in detail in order to fi nd out the risk factors and the relation of age and occurrence of neurologic complications has been assessed. Patients and Methods: In this retrospective study, we analyzed the prospectively collected data of 510 coronary by-pass patients. Neurological morbidity and mortality were evaluated with logistic regression analysis for elderly patients. Results: Of these 510 patients, 382 (74.9%) were male and 89 (17.5%) were older than 70 years of age. Post-operative mortality, pulmonary and neurologic morbidity occurred in 27 (5.3%), 78 (15.3%) and 26 (5.1%) patients, respectively. The comparison of patients with ? 70 and > 70 years of age showed that the differences were signifi cant (mortality 4.0% vs. 11.2%, p= 0.012; pulmonary morbidity 13.5% vs. 23.6%, p= 0.022; neurologic morbidity 3.3% vs. 13.5%, p= 0.0001). Presence of cerebrovascular disease (odds ratio= 4.72; p= 0.014) and advanced age (odds ratio= 3.55; p= 0.016) were independent predictors of neurologic complications. Every year increase above 51.5 years of age was associated with 5.8% (p= 0.049) increased neurologic complication risk. Conclusion: Elderly patients have higher rates of mortality, pulmonary and neurologic morbidity after coronary by-pass operations. Although no signifi cant associations were found between age and mortality, age constitutes an independent risk factor for neurologic morbidity along with presence cerebrovascular disease.

Anahtar Kelimeler

Coronary artery by-pass grafting, neurologic dysfunction, risk factors.

Koroner Baypas Hastalarında Postoperatif Sonuçlara Yaşın Etkileri

Öz

Giriş: Bu çalışmanın amacı tek bir merkezde yaşlı hastalarda yapılan koroner baypas ameliyatlarının sonuçlarını analiz etmektir. Postoperatif nörolojik komplikasyonlar ayrıntılı olarak analiz edilmiş ve yaşla beraber diğer risk faktörlerinin nörolojik komplikasyonların oluşumuna etkisi incelenmiştir. Hastalar ve Yöntem: Bu retrospektif çalışmada 510 koroner baypas hastasının prospektif olarak toplanan verileri analiz edildi. Nörolojik morbidite ve mortalitenin yaşlı hastalarda görülme riski lojistik regresyon analiziyle incelendi. Bulgular: Çalışmada incelenen 510 hastanın 382 (%74.9)'si erkekti ve 89 (%17.5)'u 70 yaşın üzerindeydi. Postoperatif mortalite, pulmoner ve nörolojik komplikasyon sırasıyla 27 (%5.3), 78 (%15.3) ve 26 (%5.1) hastada görüldü. Yetmiş yaş ve altındaki hastalar ile 70 yaş üzerindekilerin karşılaştırılmasında bu değerler arasında istatistiksel olarak anlamlı fark mevcuttu (mortalite %4.0 ve %11.2, p= 0.012; pulmoner morbidite %13.5 ve %23.6, p= 0.022; nörolojik morbidite %3.3 ve %13.5, p= 0.0001). Serebrovasküler hastalık varlığı (OR= 4.72; p= 0.014) ve ileri yaş (OR= 3.55; p= 0.016) nörolojik komplikasyon gelişiminde anlamlı değişkenler olarak bulundu. Hastaların yaşının 51.5'in üzerinde olduğu her yıl için nörolojik komplikasyon gelişme riskinin %5.8 artmakta olduğu hesaplandı (p= 0.049). Sonuç: Yaşlı hastalarda yapılan koroner baypas ameliyatları sonrası mortalite, pulmoner ve nörolojik komplikasyonlar daha sık görülmektedir. Yaş ve mortalite arasında anlamlı bir ilişki olmasa da, ileri yaş ve serebrovasküler hastalık nörolojik komplikasyon görülme riskini artırmaktadır.

Anahtar Kelimeler

Koroner arter baypas grefti, nörolojik disfonksiyon, risk faktörleri

Kaynakça

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