Predictors of surgical mortality and discharge status after coronary artery bypass grafting in patients 80 years and older

被引:27
作者
Gopaldas, Raja R. [1 ,2 ]
Chu, Danny [1 ,2 ]
Dao, Tam K. [3 ,4 ]
Huh, Joseph [1 ,2 ]
LeMaire, Scott A. [1 ,2 ]
Coselli, Joseph S. [1 ,2 ]
Bakaeen, Faisat G. [1 ,2 ,5 ]
机构
[1] Baylor Coll Med, Div Cardiothorac Surg, Houston, TX 77030 USA
[2] St Lukes Episcopal Hosp, Texas Heart Inst, Sect Adult Cardiac Surg, Houston, TX USA
[3] Baylor Coll Med, Dept Psychiat & Behav Sci, Houston, TX 77030 USA
[4] Univ Houston, Dept Educ Psychol, Houston, TX USA
[5] Michael E DeBakey VAMC, Dept Cardiothorac Surg, Houston, TX USA
关键词
Age 80 and older; Coronary artery bypass; Monality; Patient discharge; ADMINISTRATIVE DATA; CARDIAC-SURGERY; OCTOGENARIANS; COMORBIDITY; OUTCOMES; SCORES; INDEX;
D O I
10.1016/j.amjsurg.2009.07.007
中图分类号
R61 [外科手术学];
学科分类号
摘要
BACKGROUND: Little is known about the outcomes and predictors of discharge status (DCS) in elderly patients after coronary artery bypass grafting (CABG). METHODS: By using the 2004 Nationwide Inpatient Sample database, we identified 5,731 patients aged 80 years and older who underwent primary isolated CABG. Multivariate logistic regression analyses were used to identify independent predictors of surgical mortality and DCS. RESULTS: The mean patient age was 82.8 +/- 2.5 years. The surgical mortality rate was 7%. Only 21% of patients had a routine hospital discharged the rest used home health care (27%) or were transferred to a rehabilitation unit or another care facility (45%). Older age, female sex, a higher comorbidity index, and referral from the emergency room were independent predictors of surgical mortality and a nonroutine DCS (P < .05 for all). In addition, DCS was associated with the patients' level of income and the expected payer. CONCLUSIONS: Although patients aged 80 years and older have acceptable CABG-related mortality risk, many of these patients require further specialized care at discharge. Published by Elsevier Inc.
引用
收藏
页码:633 / 638
页数:6
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