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Association between older age and outcome after cardiac surgery: A population-based cohort study Open Access


Author or creator
Wang, Wei
Bagshaw, Sean M.
Norris, Colleen M.
Zibdawi, Rami
Zibdawi, Mohamad
MacArthur, Roderick
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Cardiac Surgery
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Research Material
Objective Octogenarians (aged???80 years) are increasingly being referred for cardiac surgery. We aimed to describe the morbidity, mortality, and health services utilization of octogenarians undergoing elective cardiac surgery. Methods Retrospective population-based cohort study of adult patients receiving elective cardiac surgery between January 1 2004 and December 31 2009. Primary exposure was age ?80 years. Outcomes were 30-day, 1- and 5-year mortality, post-operative complications, and ICU/hospital lengths of stay. Multi-variable logistic and Cox regression analyses were used to explore the association between older age and outcome. Results Of 6,843 patients receiving cardiac surgery, 544 (7.9%) were octogenarians. There was an increasing trend in the proportion of octogenarians undergoing surgery during the study period (0.3% per year, P?=?0.073). Octogenarians were more likely to have combined procedures (valve plus coronary artery bypass or multiple valves) compared with younger strata (p?0.001). Crude 30-day, 1-year and 5-year mortality for octogenarians were 3.7%, 10.8% and 29.0%, respectively. Compared to younger strata, octogenarians had higher adjusted 30-day (OR 4.83, 95%CI 1.30-17.92; P?=?0.018) and 1-year mortality (OR 4.92; 95% CI, 2.32-10.46. P<0.001). Post-operative complications were more likely among octogenarians. Octogenarians had longer post-operative stays in ICU and hospital, and higher rates of ICU readmission (P?0.001 for all). After multi-variable adjustment, age ? 80 years was an independent predictor of death at 30-days and 1 year. Conclusions Octogenarians are increasingly referred for elective cardiac surgery with more combined procedures. Compared to younger patients, octogenarians have a higher risk of post-operative complications, consume greater resources, and have worse but acceptable short and long-term survival.
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© 2014 Wang et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
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Wang, W., Bagshaw, S. M., Norris, C. M., Zibdawi, R., Zibdawi, M., & MacArthur, R. 2014. Association between older age and outcome after cardiac surgery: A population-based cohort study. Journal of Cardiothoracic Surgery, 9(1). doi: 10.1186/s13019-014-0177-6
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