PMID- 33821496
OWN - NLM
STAT- MEDLINE
DCOM- 20210610
LR  - 20210610
IS  - 1540-8191 (Electronic)
IS  - 0886-0440 (Linking)
VI  - 36
IP  - 7
DP  - 2021 Jul
TI  - Impact of risk factors on in-hospital mortality for octogenarians undergoing 
      cardiac surgery.
PG  - 2400-2406
LID - 10.1111/jocs.15532 [doi]
AB  - BACKGROUND: Octogenarians undergoing cardiac surgery have higher mortality than 
      their younger counterparts. OBJECTIVES: To determine if various risk factors have 
      the same effect on mortality in octogenarians as in younger patients. METHODS: 
      The National Inpatient Sample data set from 2004 to 2014 was queried to select 
      patients aged 65 years and older who underwent either coronary artery bypass 
      grafting (CABG), valvular heart surgery (VHS), or both (CABG + VHS) within 10 
      days of hospital admission. The patients were divided into two groups 65-79 years 
      and 80 years and greater. Hospital mortality, patient demographics, 
      comorbidities, and type of hospital admission was evaluated and compared using 
      chi(2) and multivariable logistic regressions. RESULTS: About 397,713 patients were 
      identified including 86,345 (21.7%) aged 80 and above. Octogenarians had higher 
      in-hospital mortality for all procedures: CABG (4.94% vs. 2.39%, p < .001), VHS 
      (5.49% vs. 4.08%, p < .001), and CABG + VHS (7.59% vs. 5.95%, p < .001), and this 
      relationship persisted when gender, race, comorbidities, and type of hospital 
      admission were controlled for: CABG (odds ratio [OR] = 1.71; 95% confidence 
      interval [CI] 1.62-1.81); VHS (OR = 1.18; 95% CI 1.11-1.27); and CABH + VHS 
      (OR = 1.17; 95%CI 1.10-1.26). Female gender, renal, or heart failure, nonelective 
      admission, and CABG + VHS were associated with increased risk of in-hospital 
      mortality. Octogenarians had higher rates of these factors (p < .001). The effect 
      size of renal and heart failure and type of surgery was smaller for 
      octogenarians. CONCLUSIONS: Octogenarians undergoing cardiac surgery have higher 
      rates of nonelective admissions, renal and heart failure, and female gender, 
      which are most strongly associated with in-hospital mortality. Differing effect 
      sizes suggest that certain risk factors, such as renal and heart failure, 
      contribute more to mortality in younger patients.
CI  - (c) 2021 Wiley Periodicals LLC.
FAU - Volk, Lindsay
AU  - Volk L
AUID- ORCID: 0000-0001-7042-9740
AD  - Department of Cardiothoracic Surgery, Rutgers Robert Wood Johnson Medical School, 
      New Brunswick, New Jersey, USA.
FAU - Chao, Joshua
AU  - Chao J
AD  - Department of Cardiothoracic Surgery, Rutgers Robert Wood Johnson Medical School, 
      New Brunswick, New Jersey, USA.
FAU - Dombrovskiy, Viktor
AU  - Dombrovskiy V
AD  - Department of Cardiothoracic Surgery, Rutgers Robert Wood Johnson Medical School, 
      New Brunswick, New Jersey, USA.
FAU - Ikegami, Hirohisa
AU  - Ikegami H
AD  - Department of Cardiothoracic Surgery, Rutgers Robert Wood Johnson Medical School, 
      New Brunswick, New Jersey, USA.
FAU - Russo, Mark J
AU  - Russo MJ
AD  - Department of Cardiothoracic Surgery, Rutgers Robert Wood Johnson Medical School, 
      New Brunswick, New Jersey, USA.
FAU - Lemaire, Anthony
AU  - Lemaire A
AD  - Department of Cardiothoracic Surgery, Rutgers Robert Wood Johnson Medical School, 
      New Brunswick, New Jersey, USA.
FAU - Lee, Leonard Y
AU  - Lee LY
AD  - Department of Cardiothoracic Surgery, Rutgers Robert Wood Johnson Medical School, 
      New Brunswick, New Jersey, USA.
LA  - eng
PT  - Journal Article
DEP - 20210406
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Aged, 80 and over
MH  - *Cardiac Surgical Procedures
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - *Postoperative Complications
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - coronary artery disease
OT  - valve repair/replacement
EDAT- 2021/04/07 06:00
MHDA- 2021/06/11 06:00
CRDT- 2021/04/06 06:03
PHST- 2020/12/22 00:00 [revised]
PHST- 2020/11/04 00:00 [received]
PHST- 2021/01/21 00:00 [accepted]
PHST- 2021/04/07 06:00 [pubmed]
PHST- 2021/06/11 06:00 [medline]
PHST- 2021/04/06 06:03 [entrez]
AID - 10.1111/jocs.15532 [doi]
PST - ppublish
SO  - J Card Surg. 2021 Jul;36(7):2400-2406. doi: 10.1111/jocs.15532. Epub 2021 Apr 6.