Long term outcomes and quality of life in octogenarians after coronary artery surgery

Objective: Coronary artery surgery in octogenarians is carried out in an increasing frequency. We tried to determine long-term outcome and quality of life after coronary artery surgery in this patient group.

Patients and methods: From 3311 patients undergoing isolated CABG surgery in two centers in the years 2005 and 2006, 240 (7.2%) were older than 80 years (mean age 82.3 years, 57.1% male). The octogenarians were analyzed regarding perioperative major adverse cardiovascular events (MACE), late mortality and quality of life (SF 12 questionnaire) and compared to younger patients (mean age 66.8 years, 61.4% male) using propensity-score matching. The mean follow-up time of 30-day survivors was 2.8 years, follow-up completeness 97.1%.

Results: In the multivariate analysis, age was a risk factor for early death (OR 4.28, 1.59–11.53 95% CI) and perioperative MACE (OR 2.78, 1.44–5.37 95% CI). 5-year survival was 59.7% in the octogenarians and 86.1% in the young group. 95.2% of the octogenarians lived alone, with a partner or with relatives, only 4.8% required permanent nursing care. While the octogenarians' quality of life was worse regarding body functions, it was better regarding psychic functions compared to the young group. 83.9% of the octogenarians would recommend surgery to their friends and relatives for relief of symptoms.

Conclusion: Octogenarians can undergo CABG surgery with an acceptable risk for early death. Though late mortality is high, late quality of life is comparable to that of younger patients.