One-year follow up after cardiac surgery in the elderly

Aims: An increasing number of elderly people develop cardiac disease requiring surgery. Because of increased operative risk, estimation of long-term benefit after surgery is becoming increasingly important. Very little is known of the long-term course after cardiac surgery in the elderly. Aim of this study was the evaluation of the prognostic value of geriatric assessment prior to geriatric surgery.

Methods: 500 patients underwent geriatric assessment on the day before cardiac surgery. At one year follow patients or their relatives were contacted by telephone. Data on one year mortality are available for all patients.

Results: Mean age was 77 ± 4 years. Postoperative 30-day mortality was 2.9%. During the year after surgery another 19 patients died (4%). Cause of death was post-surgical complications in 3 patients, cardiac disease in 2 patients and unknown in 10 patients. 86% of the patients or their relatives (n = 404) were available for telephone interview follow up. 9.7% reported a decrease in activities of daily life (ADL, Barthel index). Ten of these patients required assistance in basic daily activities (Pflegestufe), 6 patients had moved into a nursing home. Dyspnoea was complained of by 6.2%, fatigue by 5.4% of the patients, frequent dizziness by 2.2% and worsened cognitive abilities by 1.2%.

Conclusion: One year follow up after cardiac surgery in this cohort of elderly patients showed favourable results. 10% of the patients lost some ability to perform activities of daily living and 1.5% had to move into a nursing home. Only 5% of the patients complained of daily symptoms of cardiac disease like dyspnea, dizziness or fatigue.