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Volume 198, Issue 5, Pages 633-638 (November 2009)


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Predictors of surgical mortality and discharge status after coronary artery bypass grafting in patients 80 years and older

Raja R. Gopaldas, M.D.ab, Danny Chu, M.D.ab, Tam K. Dao, Ph.D.cd, Joseph Huh, M.D.ab, Scott A. LeMaire, M.D.ab, Joseph S. Coselli, M.D.ab, Faisal G. Bakaeen, M.D.abeCorresponding Author Informationemail address

Received 28 April 2009; received in revised form 2 July 2009

Abstract 

Background

Little is known about the outcomes and predictors of discharge status (DCS) in elderly patients after coronary artery bypass grafting (CABG).

Methods

By using the 2004 Nationwide Inpatient Sample database, we identified 5,731 patients aged 80 years and older who underwent primary isolated CABG. Multivariate logistic regression analyses were used to identify independent predictors of surgical mortality and DCS.

Results

The mean patient age was 82.8 ± 2.5 years. The surgical mortality rate was 7%. Only 21% of patients had a routine hospital discharge; the rest used home health care (27%) or were transferred to a rehabilitation unit or another care facility (45%). Older age, female sex, a higher comorbidity index, and referral from the emergency room were independent predictors of surgical mortality and a nonroutine DCS (P < .05 for all). In addition, DCS was associated with the patients' level of income and the expected payer.

Conclusions

Although patients aged 80 years and older have acceptable CABG-related mortality risk, many of these patients require further specialized care at discharge.

a Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, TX, USA

b Section of Adult Cardiac Surgery, The Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, TX, USA

c Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, USA

d Department of Educational Psychology, University of Houston, Houston, TX, USA

e Department of Cardiothoracic Surgery, Michael E. DeBakey VAMC, Houston, TX, USA

Corresponding Author InformationCorresponding author. Tel.: +1-832 489 3202; fax: +1-713 794 7352

PII: S0002-9610(09)00420-6

doi:10.1016/j.amjsurg.2009.07.007


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