Elective and urgent coronary surgery in octogenarians.

Objectives: To analyze the influence of surgical myocardial revascularization on early and late mortality in octogenarians and compare the survival rates with age adjusted general population.

Methods: Between 2007 and 2014, 182 octogenarian patients underwent elective or urgent coronary artery bypass grafting surgery. Logistic regression was performed to evaluate the in-hospital mortality predictors. The comparison of long term survival between our population and age adjusted general population was made using one-sample log-rank test.

Results: The in-hospital mortality was 4,4% and its predictors on univariable analysis were non sinus rhythm (p=0,001), acute coronary syndrome less than 7 days prior to surgery (p=0,021), ejection fraction less than 50% (p=0,04) and the need for conversion to on pump surgery (p=0,04). On multivariate logistic regression non sinus rhythm and acute myocardial infarction less than 7 days before surgery were independent predictors of in-hospital mortality. Follow-up at one-year showed survival rate of 86,2% and at five years 58,4%. There was no significant difference in survival rates between the study group and the age adjusted standard population (p=0,96). The group was divided in two groups: (1) complete revascularization and (2) incomplete revascularization. There was no significant difference in survival (p=0,32 and p=0,19, respectively) compared to the age adjusted standard population.

Conclusions: Coronary artery bypass grafting in octogenarians is safe and has an important impact on long term survival, with five-year survival being similar to the age adjusted standard population.