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Journals / Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi / 2025 / Volume: 12 Issue: 3

Preoperative and Postoperative Risk Factors in Septuagenarian and Elderly Patients Undergoing Open Heart Surgery: A Single-Center Experience

Açık Kalp Cerrahisi Yapılmış Yetmiş Yaş ve Üzeri Hastalarda Preoperatif ve Postoperatif Risk Faktörleri: Tek Merkez Deneyimi

Hande İştar(Muğla Sıtkı Koçman University Medical Faculty, Department of Cardiovascular Surgery)0000-0002-7150-0171
Buğra Harmandar(Muğla Sıtkı Koçman University Medical Faculty, Department of Cardiovascular Surgery)0000-0002-7487-1779
Melike Korkmaz Toker(Muğla Sıtkı Koçman University Medical Faculty, Department of Anaesthesiology & Reanimation)0000-0003-1916-4454
Fulden Cantaş Türkiş(Muğla Sıtkı Koçman University Medical Faculty, Department of Biostatistic)0000-0002-7018-7187
Pages
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Publication Date
2025-12-29
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Despite increased costs and longer hospital stays, cardiac operations can be successfully performed in septuagenarian and elderly patients.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Life expectancy is improving worldwide.
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Key Findings & Data:We retrospectively collected the medical records of 104 patients aged >70 years who underwent open heart surgery between 2018 and 2024.
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Conclusion & Impact:Despite increased costs and longer hospital stays, cardiac operations can be successfully performed in septuagenarian and elderly patients.
🔬Design:Research Article
📍Scope:2018 Verileri
⚙️Variables:Cardiac Surgery · Mortality · Septuagenerian

Abstract

Life expectancy is improving worldwide. The number of septuagenarian and older patients requiring open heart surgery is increasing. The aim of this study was to determine the risk factors associated with in-hospital mortality and poor outcomes in septuagenarian and elderly patients undergoing various open heart surgery procedures in regards of gender. We retrospectively collected the medical records of 104 patients aged >70 years who underwent open heart surgery between 2018 and 2024. Preoperative comorbidities, cross-clamp time, cardiopulmonary bypass time, postoperative bleeding, acute kidney insufficiency, arrhythmia, stroke, low cardiac output, sepsis, duration of mechanical ventilation, length of intensive care unit and hospital stays, mortality were evaluated. The mean age was 74.27 ± 4.80 years; that of women was 74.9 ± 4.9 years, and men was 73.7 ± 4.6 years. Preoperative myocardial infarction was more frequent in men. Coronary artery bypass grafting and thoracic aorta surgery were more frequent in men and women, respectively. Women were more affected by postoperative atrial fibrillation, more frequently required extended mechanical ventilatory support, and had longer ICU stays. Hosmer–Lemeshow and Omnibus tests revealed that age of >76 years, cardiopulmonary bypass time longer than 200 minutes, revision for bleeding, low cardiac output were significant predictors of in-hospital mortality. Despite increased costs and longer hospital stays, cardiac operations can be successfully performed in septuagenarian and elderly patients.

Özet

Günümüzde uzun yaşam beklentisi artmaktadır ve açık kalp cerrahisi gereksinimi olan yetmiş yaş ve üzerindeki hastalar dünya çapında artış göstermektedir. Çalışmamızda, farklı açık kalp cerrahisi prosedürleri geçiren 70 yaş ve üzerindeki hastaların cinsiyete göre, kötü prognoz ve yatış sırasındaki ölümlerine neden olan risk faktörlerinin belirlenmesi amaçlanmıştır. 2018-2024 yılları arasında açık kalp cerrahisi yapılan 70 yaş ve üzeri 104 hastanın medikal bilgileri derlenmiştir. Preoperatif ek hastalıkları, aort kros klemp süresi, kardiyo-pulmoner bypass süresi, postoperatif kanama, akut böbrek yetmezliği, aritmi, inme, düşük kalp debisi, sepsis, ventilatör destek süresi, yoğun bakım ve hastane yatış süresi, ölüm oranları değerlendirildi. Hastaların yaş ortalaması 74.27 +/- 4.80 (min 70-maks. 89) (kadın 74,9 +/- 4,9 ve erkek 73,7 +/- 4,6) idi. Preoperatif miyokard infarktüsü erkeklerde daha sıktı, koroner bypass erkeklerde ve torasik aort cerrahisiyse kadınlarda daha sıktı. Postoperatif atrial fibrilasyon kadınlarda daha sıktı. Ayrıca kadınlar uzamış ventilatör desteğine daha çok gereksinim duyuyordu ve daha uzun yoğun bakım yatış sürelerine sahipti. Hosmer-Lemeshow ve Omnibus tesleri, 76 yaşın üzerinde olma, 200 dakikanın üzerinde kardiyopulmoner bypass süresi, kanama revizyonu ve düşük kalp debisi faktörlerinin mortaliteyi öngörme açısından önemli olduğunu gösterdi. Artmış maliyet ve uzamış yatış sürelerine rağmen 70 yaş ve üzerindeki hastalarda açık kalp cerrahisi uygulanabilir.

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Cite This Article

İştar, H., Harmandar, B., Toker, M. K., Türkiş, F. C. (2025). Preoperative and Postoperative Risk Factors in Septuagenarian and Elderly Patients Undergoing Open Heart Surgery: A Single-Center Experience. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, Volume: 12 Issue: 3. https://doi.org/10.47572/muskutd.1682439

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