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Outcomes of cardiac surgery in senior aged patients with ventricular dysfunction: analysis of a large national database
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 t...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Science Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7868914/ https://www.ncbi.nlm.nih.gov/pubmed/33613654 http://dx.doi.org/10.11909/j.issn.1671-5411.2021.01.006 |
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author | TANG, Han-Wei CHEN, Kai HOU, Jian-Feng HUANG, Xiao-Hong LIU, Sheng MA, Han-Ping HU, Sheng-Shou |
author_facet | TANG, Han-Wei CHEN, Kai HOU, Jian-Feng HUANG, Xiao-Hong LIU, Sheng MA, Han-Ping HU, Sheng-Shou |
author_sort | TANG, Han-Wei |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7868914 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Science Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-78689142021-02-18 Outcomes of cardiac surgery in senior aged patients with ventricular dysfunction: analysis of a large national database TANG, Han-Wei CHEN, Kai HOU, Jian-Feng HUANG, Xiao-Hong LIU, Sheng MA, Han-Ping HU, Sheng-Shou J Geriatr Cardiol Research Article 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. Science Press 2021-01-28 /pmc/articles/PMC7868914/ /pubmed/33613654 http://dx.doi.org/10.11909/j.issn.1671-5411.2021.01.006 Text en Copyright and License information: Journal of Geriatric Cardiology 2021 http://creativecommons.org/licenses/by-nc-sa/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/ |
spellingShingle | Research Article TANG, Han-Wei CHEN, Kai HOU, Jian-Feng HUANG, Xiao-Hong LIU, Sheng MA, Han-Ping HU, Sheng-Shou Outcomes of cardiac surgery in senior aged patients with ventricular dysfunction: analysis of a large national database |
title | Outcomes of cardiac surgery in senior aged patients with ventricular dysfunction: analysis of a large national database |
title_full | Outcomes of cardiac surgery in senior aged patients with ventricular dysfunction: analysis of a large national database |
title_fullStr | Outcomes of cardiac surgery in senior aged patients with ventricular dysfunction: analysis of a large national database |
title_full_unstemmed | Outcomes of cardiac surgery in senior aged patients with ventricular dysfunction: analysis of a large national database |
title_short | Outcomes of cardiac surgery in senior aged patients with ventricular dysfunction: analysis of a large national database |
title_sort | outcomes of cardiac surgery in senior aged patients with ventricular dysfunction: analysis of a large national database |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7868914/ https://www.ncbi.nlm.nih.gov/pubmed/33613654 http://dx.doi.org/10.11909/j.issn.1671-5411.2021.01.006 |
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