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

Am J Surg. 2009 Nov;198(5):633-8. doi: 10.1016/j.amjsurg.2009.07.007.


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.

MeSH terms

  • Aged, 80 and over
  • Coronary Artery Bypass / mortality*
  • Female
  • Heart Diseases / mortality*
  • Heart Diseases / surgery
  • Heart Failure / surgery
  • Humans
  • Male
  • Multivariate Analysis
  • Myocardial Infarction / mortality
  • Myocardial Infarction / surgery
  • Outcome Assessment, Health Care*
  • Patient Discharge / statistics & numerical data*
  • Peripheral Vascular Diseases / mortality
  • Peripheral Vascular Diseases / surgery
  • Social Class
  • United States / epidemiology