Coronary bypass surgery in a group of operated patients over 75 years of age – 15 year study

Radoslaw Zwolinski, Janusz Zaslonka, Ryszard Jaszewski, Witold Pawlowski, Bogdan Jegier, Andrzej Walczak, Leszek Markuszewski, Alicja Iwaszkiewicz, Stanislaw Ostrowski

Summary
The benefits of coronary revascularisation for ischaemic heart disease (IHD) are well-documented for patients with coronary artery disease (CAD) in general. In the last two decades concomitant improvements in medical treatment and interventional cardiology for CAD have changed referral patterns for CABG, and have increased the number of older and high-risk patients proceeding to surgery. This study was undertaken to analyze the trends and results of surgical treatment during the last 15 years.
Purpose: The study was undertaken to outline changes in an elderly (> 75) population of patients referred for CABG during the last 15 years.
Material: From 1988 to 2002, 5320 patients underwent the CABG procedure. This study included all operated patients over 75 years of age.
Methods: The 15 years were subdivided into five time periods of 3 years. Group 1 was 1988-1990, group 2 1991-1993, group 3 1994-1996, group 4 1997-1999, and group 5 between 2000 and 2002.
Results: There is a significant increase in operated patients over 75 years of age, and this population is getting older. On the basis of EuroSCORE our findings show an increase in elderly patients who were referring to CABG facing a medium or high risk from surgery. Despite the increase in high-risk patients, the risk of hospital mortality has not significantly changed but there is an increased number of perioperative morbidities. We therefore believe that earlier indication for CABG, especially in an elderly population of patients, should be revised, and expanded criteria for CABG should be considered.

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