Resumo

MONTERO, HUGO et al. Cirugía cardíaca en octogenarios: Comparación de los resultados a corto y mediano plazo con la población menor a 80 años. Rev.Urug.Cardiol. [online]. 2007, vol.22, n.1, pp.6-14. ISSN 1688-0420.

SUMMARY Purpose: To evaluate short and mid-term results of cardiac surgery in octogenarians. Methods: All patients operated on between 1/1/200 and 31/12 2005 (n=5.450) were prospectively included. Hemodinamic parameters, preoperative risk factors, and postoperative evolution were analysed. Patients were separated in 2 groups: < 80 years old (G1), ³ 80 years old (G2). Statistical analysis was performed with “t” test, Mann-Whitney test, Chi square test, Kaplan-Meier method, log-rank test and logistic regresion model. Results: Surgery was performed on 217 patients = 80 años (3,98%), average 82,2 years (rank: 80-90). No differences were found in: COPD, periferial vascular disease; cerebro-vascular disease, high blood pressure, previous cardiac surgery, hemodinamic inestability, LVEF, previous AMI. There were differences between G1 and G2 in: diabetes (24,8% versus 14,3%; p<0,0001), smoking (23,2% versus 5,1%; p<0,0001), females (33% versus 45,6%; p<0,001), estimated glomerular filtration (75,5% versus 46,6 ml/min; p<0,0001), coronary surgery alone (63,7% versus 43,3%; p<0,0001), aortic valve replacement (25,2% versus 52,5%; p<0,0001), EuroSCORE (5,7± 2,8 versus 9,1± 1,9; p<0,001). The operative mortality (OM) was 6,3% versus 9,7% (p<0,05), estimated mortality with EuroSCORE was 6,8 vs 14,9% (p<0,05). Patiets in G2 had longer length of stay (LOS), globally and in ICU, longer ventilatory mechanical support and reintervention for bleeding. Patients in both groups had similar incidence of stroke, perioperative AMI and 5 years mortality (21,3% versus 17,3%; p=NS). Conclusions: Cardiac surgery is a reasonable option in selected octogenarians, with greater operative mortality and hospital stay. Long run prognosis is similar in both groups.

Palavras-chave : THORACIC SURGERY; OCTOGENARIANS; EVALUATION OF RESULTS; OF THERAPEUTIC; INTERVENTIONS; TREATMENT OUTCOME.

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