Background:
Aortic stenosis (AS) in octogenarians is most common and debilitating second to coronary artery disease, leading to poor quality of life (QOL). AS has higher mortality comparison to isolated revascularization (CABG) surgery. Studies indicated the benefits of both types of surgeries in octogenarians in improvement of functionality and QOL. Objective of this study was to assess long-term survival, functional status, living arrangements and QOL in the octogenarians in aortic valve and CABG surgery.
Methods:
Between September 2000 and September 2006, 304 consecutive patients aged 80-92 years (mean: 83.2 ± 2.8) who had CABG (196) and AVR (108) with or without CABG were identified. All survivors were followed prospectively for a mean period of 36.5 months (7-78). Their QOL and functional status was assessed by using items from the Barthel index and Karnofsky performance score. In this study we used observable descriptive measures to describe QOL (i.e. Phenomenology: the study of lived experience), in a number of domain activities of day-today life in our elderly patients.
Results:
Overall 30-day in-hospital mortality (CABG/AVR; n::%) rate was (24/10::12.2/9.2%). The non-adjusted survival rate was 82.7/78.2% and 72.4/66.5% at 1 and 3 years respectively. Among the 207 (136/71::69.4/65.7%) survivors from a cohort of 304, (89/44::65.4/62.0%) were autonomous, (38/18::27.9/25.4%) were semiautonomous, and 9/9::6.6/12.6%) were dependents. Among the survivors (103/47::75.7/66.2%) living in own homes, (24/15::17.6/21.1%) in residences and (9/9::6.6/12.6%) in the supervised setting. The surviving patients were involved social (133/68::97.8/95.8%), cognitive (132/68::97/95.9%), physical (126/65::92.6/91.5%), and/or volunteer and creative activities (27/18::19.8/25.3%). All survivors were cardiac symptoms free.
Conclusions:
Early and long-term survival in CABG and AVR group was not significantly different. More than 90% of survivors were physically active. Functional status and QOL were not significantly different in two groups. This long-term information can help when considering risks and benefits of Cardiac surgery and planning the future need for health care resources among octogenarians.
Long-term survival and quality of life in Jehovah’s witnesses after cardiac surgery: a case control study
