Outcomes of cardiac surgery in senior aged patients with ventricular dysfunction: analysis of a large national database

Han-Wei TANG; Kai CHEN; Jian-Feng HOU; Xiao-Hong HUANG; Sheng LIU; Han-Ping MA; Sheng-Shou HU

doi:10.11909/j.issn.1671-5411.2021.01.006

Volume 18 Issue 1

Feb. 2021

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Article Navigation > Journal of Geriatric Cardiology > 2021 > 18(1): 1-9

Please cite this article as: TANG HW, CHEN K, HOU JF, HUANG XH, LIU S, MA HP, HU SS. Outcomes of cardiac surgery in senior aged patients with ventricular dysfunction: analysis of a large national database. J Geriatr Cardiol 2021; 18(1): 1−9. DOI: 10.11909/j.issn.1671-5411.2021.01.006

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Please cite this article as: TANG HW, CHEN K, HOU JF, HUANG XH, LIU S, MA HP, HU SS. Outcomes of cardiac surgery in senior aged patients with ventricular dysfunction: analysis of a large national database. J Geriatr Cardiol 2021; 18(1): 1−9. DOI: 10.11909/j.issn.1671-5411.2021.01.006

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Outcomes of cardiac surgery in senior aged patients with ventricular dysfunction: analysis of a large national database

doi: 10.11909/j.issn.1671-5411.2021.01.006

1.
Department of Cardiovascular Surgery, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
2.
Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China

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Corresponding author: huss@fuwaihospital.org
Available Online: 2021-02-07
Publish Date: 2021-01-28

Abstract

Abstract

OBJECTIVE In patients undergoing cardiac surgery, reduced preoperative ejection fraction (EF) and senior age are associated with a worse outcome. As most outcome data available for these patients are mainly from Western surgical populations involving specific surgery types, our aim is to evaluate the real-world characteristics and perioperative outcomes of surgery in senior-aged heart failure patients with reduced EF across a broad range cardiac surgeries. METHODS Data were obtained from the China Heart Failure Surgery Registry (China-HFSR) database, a nationwide multicenter registry study in mainland China. Multiple variable regression analysis was performed in patients over 75 years old to identify risk factors associated with mortality. RESULTS From 2012 to 2017, 578 senior-aged (> 75 years) patients were enrolled in China HFSR, 21.1% of whom were female. Isolated coronary bypass grafting (CABG) were performed in 71.6% of patients, 10.1% of patients underwent isolated valve surgery and 8.7% received CABG combined with valve surgery. In-hospital mortality was 10.6%, and the major complication rate was 17.3%. Multivariate analysis identified diabetes mellitus (odds ratio (OR) = 1.985), increased creatinine (OR = 1.007), New York Heart Association (NYHA) Class III (OR = 1.408), NYHA class IV (OR = 1.955), cardiogenic shock (OR, 6.271), and preoperative intra-aortic balloon pump insertion (OR = 3.426) as independent predictors of in-hospital mortality. CONCLUSIONS In senior-aged patients, preoperative evaluation should be carefully performed, and strict management of reversible factors needs more attention. Senior-aged patients commonly have a more severe disease status combined with more frequent comorbidities, which may lead to a high risk in mortality.

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References(34)

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