PMID- 9377949
OWN - NLM
STAT- MEDLINE
DCOM- 19971110
LR  - 20190514
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 112
IP  - 4
DP  - 1997 Oct
TI  - Prognosis and quality of life after valve surgery in patients older than 75 
      years.
PG  - 885-94
AB  - BACKGROUND: Assessment of quality of life has become an increasingly important 
      aspect of the risk-benefit analysis of any therapeutic intervention, particularly 
      in high-risk populations, such as the elderly. METHODS: Clinical outcomes of 147 
      consecutive patients older than 75 years undergoing valve surgery between 1992 
      and 1995 were reviewed. Long-term quality of life was assessed using a modified 
      version of the Duke University Medical Outcomes Study system. RESULTS: Mean age 
      was 79.3+/-4 years, range was 75 to 89 years, and 67% (99/147) were male. 
      Preoperatively, 128 patients (87%) were in New York Heart Association (NYHA) 
      functional class III/IV. Fifty-two percent (77/147) of the operations were 
      nonelective. Concomitant coronary artery bypass grafting was performed in 69 
      patients (47%). Thirty-day hospital mortality was 7.5% (11/147). Mean follow-up 
      for 98% (133/136) of hospital survivors was 30+/-13 months (range, 2 to 55 
      months). Actuarial survival at 55 months was 71+/-6%-equivalent to a general 
      age-, race-, and gender-matched population reported in the Life Tables of the US 
      National Center for Health Statistics. At the time of follow-up, 112 patients 
      (96%) lived at home, 78% (91/116) defined their health between good to excellent, 
      and 81% (93/114) stated that the operation improved their health status. 
      Ninety-seven percent (112/116) were able to bathe and dress independently, 92% 
      (104/113) could walk at least one block, and 88.5% (100/113) could climb at least 
      one flight of stairs. Moderate to vigorous activities could be performed by 59.2% 
      (67/113). Overall, at the time of follow-up, 81% (95/117) were in NYHA class 
      I/II. CONCLUSION: In a selected patient population, valve surgery in the elderly 
      is associated with acceptable early morbidity and mortality. Long-term survival 
      and quality of life are excellent. These facts strongly support the performance 
      of these procedures in patients older than 75 years.
FAU - Shapira, O M
AU  - Shapira OM
AD  - Department of Cardiothoracic Surgery, Boston Medical Center, MA 02118, USA. 
      oshapira@acs.bu.edu
FAU - Kelleher, R M
AU  - Kelleher RM
FAU - Zelingher, J
AU  - Zelingher J
FAU - Whalen, D
AU  - Whalen D
FAU - Fitzgerald, C
AU  - Fitzgerald C
FAU - Aldea, G S
AU  - Aldea GS
FAU - Shemin, R J
AU  - Shemin RJ
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
SB  - IM
MH  - Activities of Daily Living
MH  - Actuarial Analysis
MH  - Aged
MH  - Aged, 80 and over
MH  - *Aging
MH  - Aortic Valve/*surgery
MH  - Case-Control Studies
MH  - Coronary Artery Bypass/adverse effects
MH  - Elective Surgical Procedures
MH  - Emergencies
MH  - Female
MH  - Follow-Up Studies
MH  - Health Status
MH  - Hospital Mortality
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Mitral Valve/*surgery
MH  - Multivariate Analysis
MH  - Patient Satisfaction
MH  - Postoperative Complications
MH  - Prognosis
MH  - *Quality of Life
MH  - Residence Characteristics
MH  - Retrospective Studies
MH  - Risk
MH  - Risk Factors
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - Walking/physiology
EDAT- 1997/10/23 00:00
MHDA- 1997/10/23 00:01
CRDT- 1997/10/23 00:00
PHST- 1997/10/23 00:00 [pubmed]
PHST- 1997/10/23 00:01 [medline]
PHST- 1997/10/23 00:00 [entrez]
AID - S0012-3692(15)47266-6 [pii]
AID - 10.1378/chest.112.4.885 [doi]
PST - ppublish
SO  - Chest. 1997 Oct;112(4):885-94. doi: 10.1378/chest.112.4.885.