Predictors of outcome after coronary artery bypass grafting in patients older than 75 years of age

This study was designed to identify risk factors affecting mortality and morbidity in patients older than 75 years who underwent coronary artery bypass grafting (CABG) with cardiopulmonary bypass. The preoperative, perioperative, and postoperative data of 116 patients older than 75 years who underwent isolated CABG from January 1997 through April 2002 were evaluated retrospectively. Preoperatively, 82 patients (70.7%) were in CCS class III-IV and 65 (56%) were in NYHA class III-IV. Besides mortality, morbidity and survival rates, the statistical significance of predictors of outcome were investigated. Overall mortality and hospital mortality rates were 12.9% (15 patients) and 4.3%, (5 patients), respectively. Postoperative complications were observed in 56 patients (48.3%). In 25.1+/-17.6 months of follow-up, 96 (86.5%) and 101 (91%) of the surviving 111 patients (95.7%) were in NYHA class I and CCS class I, respectively. Prolonged cross-clamp time (>50 min) (p=0.018), COPD (p=0.028), and emergency operation (p=0.001) were found to be the determinants of postoperative complications. The cumulative 5-year survival rate was 77.2 +/-0.8%. Elective CABG in older patients with shorter bypass and cross-clamp times, after the management of comorbid disease, such as COPD, is a safe procedure with low mortality and morbidity rates, showing postoperative improvements in functional capacity and angina class.