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PREOPERATIVE CARDIAC SURGERY RISK ASSESSMENT BY PARSONNET SCORE IN OCTOGENARIANS: CORRELATION WITH SURVIVAL AND LIFESTYLE STUDY FREE TO VIEW

Rakesh K. Chaturvedi, MD, PhD*; Benoit deVarennes, MD, FRCS; Kevin Lachapelle, MD, FRCS
Author and Funding Information

Royal Victoria Hospital, Div. Cardiac Surgery, MUHC, McGill University, Montreal, QC, Canada


Chest


Chest. 2007;132(4_MeetingAbstracts):440a. doi:10.1378/chest.132.4_MeetingAbstracts.440a
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Abstract

PURPOSE: Concerns exist regarding cardiac surgery (CS) in the elderly due to increased postoperative morbidity and mortality. We studied long-term survival and engagement in lifestyle leisure activities in octogenarians after their CS.

METHODS: 408 consecutive octogenarians who underwent CS were reviewed. Cardiac database and medical charts were consulted for their premorbid and clinical condition. Parsonnet score (PS) was used for preoperative risk assessment. Acturial survival at 1, 3, 6 months were recorded.We divided our patients’ in 3 major categories according to their preoperative PS i.e. low (PS< 30), moderate (PS 31-40) and high (PS >40) risk, to predict early survival at 30 days, as well as at 3 and 6 months following their CS. For surviving octogenarians day today lifestyle leisure activities i.e. such as social, cognitive, physical, creative and volunteer or vocational were recorded.

RESULTS: 400 (no PS for 8 pts) patients were included for study. The average age was 82.56 years (80–92) with 215 males and 185 females. There were 266 isolated procedures (CABG, AVR, MVR) and 134 combined (CABG+ valve, multiple valves and other complex procedures). Survival: Overall 30 day survival was 86%. Low risk, PS <31 were associated with excellent early survival (94.5%) and 93% survival at 6 months. Moderate and high risk group were associated with lower early survival 86% and 60% and 6 month survival of 81% and 46% respectively (table). Leisure Activities: Actuarial survival at a mean follow-up of 37.7 months (range 5-78 months) was 66% (262pts). 93% are functionally autonomous and 7% living in long-term facilities. The surviving octogenarians (80-97yrs) were engaged different leisure activities (table).

CONCLUSION: 1) PS is a good predictor of early mortality up to 90 days following CS in octogenarians. 2) Stratified PS may help physicians and patients for preoperative CS informed decisions making for majority of octogenarians (excluding emergency situations). 3) Even in high risk group, CS improves lifestyle of Octogenarians.

CLINICAL IMPLICATIONS: This long-term information can help for planning the future need for health care resources.

DISCLOSURE: Rakesh Chaturvedi, No Financial Disclosure Information; No Product/Research Disclosure Information

Monday, October 22, 2007

2:30 PM - 4:00 PM


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