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Reich, DL MD; Kaplowitz, JS

doi: 10.1097/00000539-199802001-00094
Abstracts of Posters Presented at the International Anesthesia Research Society; 72nd Clinical and Scientific Congress; Orlando, FL; March 7-11, 1998: Cardiovascular Anesthesia

Dept. of Anesthesiology, Mount Sinai School of Medicine, New York, N.Y. 10029.

Abstract S94

The number of elderly in the U.S. population is rising. It is estimated that 47 percent of U.S. residents will live to be 80 yrs of age. There were 6.9 million people >80 yrs in 1990, and the estimate for 2050 is 25 million. [1] Cardiovascular disease is the leading cause of morbidity and mortality in the elderly. [2] Up to 40 percent of octogenarians have cardiovascular disease and up to 44 percent of people >85 yrs die from cardiac causes. [3] It is reasonable to assume that the number of cardiac surgical candidates will mirror the population shift. Using a mandatory statewide cardiac surgical database, we sought to determine the relative incidence of various adverse outcomes following cardiac surgery in the elderly.

METHODS: We reviewed the New York State Cardiac Surgery Reporting System (CSRS) Database for all cardiac surgical procedures performed at the authors' institution over a 3.5 year period (1993-6) using an IRB-approved protocol. Patients were sub-divided into categories according to age. The incidence of mortality, stroke, and postoperative lengths of stay >7 days and >14 days were compared among patients within the different age categories. Statistical analysis was performed using chi-square tables. A two-tailed p < 0.05 was considered statistically significant.

RESULTS: There were a total of 2,614 cardiac procedures performed during the period analyzed. There were 809 patients <60 yrs, 798 patients 60-69 yrs, 763 patients 70-79 yrs, and 244 patients 80-89 yrs. Mortality rate, length of stay and stroke rate all increased significantly with age. The data are summarized in Table 1.

Table 1

Table 1

CONCLUSIONS: As the number of elderly patients undergoing cardiac surgery increases, it is reasonable to measure adverse outcomes for medical and economic reasons. Our results confirm the increase in adverse outcomes with advanced age and are unique in four ways: (1) there were a large number of patients >80 yrs; (2) the study interval was 3.5 yrs; (3) the data source-a mandatory statewide instrument-has validity; and (4) we included prolonged hospital length of stay as a surrogate marker for adverse outcomes.

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1. U.S. Bureau of the Census: Projections of the Population of the United States by Age, Sex, and Race: 1988 to 2080.
2. Am J Cardiol, 1989;63:3H-4H
3. Ann Surg 1990;211:772-6
© 1998 International Anesthesia Research Society