The purpose of this study is to evaluate the difference between the mortality of patients aged more than 80 and all other adult age groups after cardiac surgery, stratified by Parsonnet score.
Cardiac surgery data base was consulted, 5983 patients were found. We stratified our population into two age groups (octogenarians and non-octogenarians) and two risk groups according to PS (40 or less and more than 40). Morbidity, postoperative complications and mortality were compared using SAS 9.2 statistical program.
We report the 90-day mortality among 5983 patients who underwent cardiac surgery at a tertiary care center from September 2000 to September 2008. The average age of the 5410 non-octogenarians and 573 octogenarians was 63.8 (SD 10.3) and 82.6 (SD 2.4) years respectively. The proportion of males of octogenarians and the non-octogenarians patients was 72% and the very elderly was 54%. The crude 90-day mortality of the non-octogenarians was 8.7% and octogenarians was 21.8%. When stratified by PS > 40, the crude 90-day mortality of the non-octogenarians and octogenarians was 33.8% and 43.7% (p value 0.08), respectively. When stratified by PS > 40, the crude 90-day mortality of the non-octogenarians and octogenarians was 33.8% and 43.7% (p value 0.08), respectively. When stratified by PS < 40, the crude 90-day mortality of the non-octogenarians and octogenarians was 4.2% and 18.2% (p value < 0.0001), respectively. The trend is consistent with each individual year as shown in the Table.
Octogenarians are at a higher risk of crude 90-day mortality than non-Octogenarians by two to three fold after cardiac surgery. The difference in risk is more evident at the lower PS and the risk of mortality is similar in the higher PS group. Mortality in non-octogenarians with high PS is because of higher preoperative morbidity.
Stratification of PS or other risk assessment system can help surgeons as well as to patients in future for informed decision making prior to cardiac surgery.
Rakesh Chaturvedi, No Financial Disclosure Information; No Product/Research Disclosure Information