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1 From the Division of Cardiothoracic Surgery, The Johns Hopkins Medical Institutions, Baltimore
Objectives: To determine the quality of life in octogenarians after open heart surgery.
Background: Despite an increasing number of cardiac operations on octogenarians, the outcome as measured by functional status, independence of living, and psychological parameters of quality of life remain unproved.
Methods: Two groups of octogenarians (group 1, undergoing operation in 1986; group 2 in 1991) were reviewed retrospectively to determine operative mortality and functional results.
Results: Group 1 (n=15, mean age of 83.2 years) and group 2 (n=53, mean age 83.0 years) were studied. Operations included isolated coronary artery bypass grafting (group 1, 10; group 2, 29) and valve replacements ± coronary artery bypass grafting ± other procedures (group 1: 5; group 2, 24). Group 1 had 9% hospital mortality and 53% actuarial survival after a mean follow-up of 6.3 years. Group 2 had 17% hospital mortality and 72% actuarial survival after a mean follow-up of 1.5 years. At follow-up, significant improvements were observed in New York Heart Association (NYHA) angina class, congestive cardiac failure class, number of cardiovascular symptoms, and indices for satisfaction with overall life and general affect in both groups. Further, group 2 also showed significant improvements in independence of living, ease of life, and Karnofsky dependency category, but these improvements were less evident in group 1 after a longer period of follow-up. At follow-up, 75% of group 1 and 84% of group 2 octogenarians would definitely have made the same decision to undergo open heart surgery in retrospect.
Conclusion: This study demonstrates improved quality of life after open heart surgery in octogenarians.
Key Words: coronary artery bypass • octogenarian • quality of life
Submitted on September 14, 1994
Accepted on March 15, 1995
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