Short- and long-term outcomes in octogenarians after coronary artery bypass surgery.

OBJECTIVES: Coronary artery surgery in octogenarians is carried out with an increasing frequency. We tried to determine short- and long-term outcomes and quality of life after coronary artery surgery in this patient group. METHODS: From 3312 patients undergoing isolated coronary artery bypass graft (CABG) surgery in two centres in the years 2004–06, 240 (7.2%) were older than 80 years (mean age 82.3 years, 57.1% male). The octogenarians were analysed regarding perioperative major adverse cardiac and cerebrovascular events (MACCE), late mortality and health-related quality of life (SF-12 questionnaire) and compared with 376 younger patients (mean age 66.8 years, 61.4% male) using propensity score matching. The mean follow-up time of 30-day survivors was 53 months, and follow-up completeness was 97.1%. RESULTS: The octogenarians’ 30-day mortality rate was 6.8% (vs 1.6% in the younger group). In the multivariate analysis, age was a risk factor for early death [odds ratio (OR) 4.28, 95% confidence interval (CI): 1.59–11.53] and perioperative MACCE (OR 2.78, 95% CI:1.44– 5.37). One-year and 3-year survivals were 94.5 and 81.4% in the octogenarians and 98 and 91.3% in the younger group. Four years after surgery, 95.2% of the octogenarians lived alone, with a partner or with relatives, and only 4.0% required permanent nursing care. 83.9% of the octogenarians would recommend surgery to their friends and relatives for relief of symptoms. CONCLUSIONS: Octogenarians can undergo CABG surgery with an acceptable risk of early death. Though late mortality is high, late quality of life is comparable with that of younger patients.