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Background <p>The role of cardiac surgery in octogenarians is debated, but limited data exist for patients aged 65–79. This study compared clinical characteristics, surgical procedures, and outcomes between patients ≥ 80 and those aged 65–79 years to evaluate whether age alone should influence surgical decisions.</p> Methods <p>We conducted a retrospective cohort study including all patients aged ≥ 65 who underwent cardiac surgery between January 2019 and December 2022. Patients were divided into two groups: 65–79 years (<i>n</i> = 217) and ≥ 80 years (<i>n</i> = 57). Demographic, clinical, and surgical data were collected and analyzed. EuroSCORE II and STS scores were evaluated as predictors of in-hospital mortality.</p> Results <p>Among 274 patients (median age 74 [IQR 69–79]), the overall in-hospital mortality rate was 11.6%, slightly higher in octogenarians, although the difference was not statistically significant (15.7% vs. 10.5%, <i>p</i> = 0.39). Octogenarians had significantly higher EuroSCORE II values (4.31 vs. 2.81, <i>p</i> &lt; 0.005), longer cardiopulmonary bypass and aortic cross-clamp times, and a higher proportion of non-elective procedures.</p> <p>There were no statistically significant differences between groups in postoperative complications, including acute kidney injury, atrial fibrillation, or cardiogenic shock. EuroSCORE II demonstrated a trend toward better discriminative performance in octogenarians (AUC 0.831; 95% CI: 0.6964–0.9656) compared to patients aged 65–79 years (AUC 0.6432; 95% CI: 0.5825–0.8095), though this did not reach statistical significance (p = 0.06175). The STS score showed moderate and consistent predictive performance across age groups, with AUCs of 0.6981 in the overall cohort, 0.6971 in patients &lt;80 years, and 0.6894 in patients ≥80 years.</p> Conclusion <p>Patients aged ≥80 years exhibited similar in-hospital mortality rates and no increase in postoperative complication rates compared to younger elderly patients. EuroSCORE II appears to outperform the STS score in predicting in-hospital mortality among octogenarians.</p>

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Cardiac surgery in older adults: a retrospective cohort study of outcomes and risk score performance in octogenarians versus patients aged 65–79 years

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月17日

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  • Javier Darío Garzón-Rodríguez,
  • Paula Liliana Torres-Gómez,
  • Karen Andrade Macias,
  • Liliana Suárez-Tequia,
  • Felipe Noriega-Acosta,
  • Edith Elianna Rodríguez-Aparicio,
  • Camilo Andrés Pérez-Velásquez,
  • David Rene Rodríguez-Lima

摘要

Background

The role of cardiac surgery in octogenarians is debated, but limited data exist for patients aged 65–79. This study compared clinical characteristics, surgical procedures, and outcomes between patients ≥ 80 and those aged 65–79 years to evaluate whether age alone should influence surgical decisions.

Methods

We conducted a retrospective cohort study including all patients aged ≥ 65 who underwent cardiac surgery between January 2019 and December 2022. Patients were divided into two groups: 65–79 years (n = 217) and ≥ 80 years (n = 57). Demographic, clinical, and surgical data were collected and analyzed. EuroSCORE II and STS scores were evaluated as predictors of in-hospital mortality.

Results

Among 274 patients (median age 74 [IQR 69–79]), the overall in-hospital mortality rate was 11.6%, slightly higher in octogenarians, although the difference was not statistically significant (15.7% vs. 10.5%, p = 0.39). Octogenarians had significantly higher EuroSCORE II values (4.31 vs. 2.81, p < 0.005), longer cardiopulmonary bypass and aortic cross-clamp times, and a higher proportion of non-elective procedures.

There were no statistically significant differences between groups in postoperative complications, including acute kidney injury, atrial fibrillation, or cardiogenic shock. EuroSCORE II demonstrated a trend toward better discriminative performance in octogenarians (AUC 0.831; 95% CI: 0.6964–0.9656) compared to patients aged 65–79 years (AUC 0.6432; 95% CI: 0.5825–0.8095), though this did not reach statistical significance (p = 0.06175). The STS score showed moderate and consistent predictive performance across age groups, with AUCs of 0.6981 in the overall cohort, 0.6971 in patients <80 years, and 0.6894 in patients ≥80 years.

Conclusion

Patients aged ≥80 years exhibited similar in-hospital mortality rates and no increase in postoperative complication rates compared to younger elderly patients. EuroSCORE II appears to outperform the STS score in predicting in-hospital mortality among octogenarians.