Assessment of preoperative risk scoring systems in geriatric and non-geriatric coronary bypass surgery patients

Authors

Keywords:

Preoperative risk scoring systems, Geriatric patient, Coronary bypass

Abstract

Aim: The need to predict mortality in patients undergoing cardiac surgery has resulted in the development of numerous preoperative risk scoring systems, which are being successfully implemented in clinical practice. Although the criteria of scoring systems use patient age as a risk factor, their effectiveness should also be evaluated in the subgroups of these systems.
Methods: Our retrospective cohort study includes all patients who underwent isolated CABG surgery at Private Akay Hospital Cardiovascular Surgery Clinic between May 2012 and March 2014. Patients were subdivided into two cohorts as geriatric (≥65 years) and non-geriatric (<65 years) patients. In this study, intraoperative deaths and deaths within 30 days postoperatively were considered as mortality. We retrospectively evaluated demographic data, preoperative risk factors, preoperative treatments, postoperative data, postoperative complications, laboratory findings, and mortality and morbidity outcomes from patient files and the hospital database.
Results: The coherence between observed and EuroSCORE II-predicted mortality, logistic Euro-SCORE-predicted mortality and Parsonnet-predicted mortality were 93%, 94%, and 89%, respectively for patients aged 65 and older, and 78%, 77%, and 71%, respectively for patients aged below 65 years (P=0.01 for all).
Conclusion: In general, we observed that EuroSCORE II, Log EuroSCORE and Log Parsonnet scoring systems are more effective in predicting mortality among elderly coronary bypass surgery patients compared to younger patients.

Downloads

Download data is not yet available.

References

Şahin M, El H, Mert FTİ. Comparison of three different sternal closure techniques after cardiac surgery in elderly patients. J Surg Med, 2018;2(3):205-9.

Türkan K. Kalp Cerrahisi Geçirecek Yaşlı Hastalarda Preoperatif Değerlendirme. GKDA Derg 2014;20(3):162-6.

Silvay G, Castillo JG, Chikwe J, Flynn B, Filsoufi F. Cardiac anesthesia and surgery in geriatric patients. Semin Cardiothorac Vasc Anesth. 2008 Mar;12(1):18-28. doi: 10.1177/1089253208316446. Epub 2008 Apr 7. PMID: 18397906.

Roques F, Michel P, Goldstone AR, Nashef SA. The logistic EuroSCORE. Eur Heart J. 2003 May;24(9):881-2. doi: 10.1016/s0195-668x(02)00799-6. PMID: 12727160

Nashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R. European system for cardiac operative risk evaluation (EuroSCORE). Eur J Cardiothorac Surg. 1999 Jul;16(1):9-13. doi: 10.1016/s1010-7940(99)00134-7. PMID: 10456395.

Parsonnet V, Dean D, Bernstein AD. A method of uniform stratification of risk for evaluating the results of surgery in acquired adult heart disease. Circulation. 1989 Jun;79(6 Pt 2):I3-12. Erratum in: Circulation 1990 Sep;82(3):1078. PMID: 2720942.

Kowalczuk-Wieteska A, Parys M, Majchrzyk I, Zembala M, Zembala M. Can the Vulnerable Elders-13 Survey (VES-13) scale replace the EuroSCORE scale in predicting complications in patients over 60 years of age undergoing cardiac surgery? Postepy Kardiol Interwencyjnej. 2019;15(2):211-7. doi: 10.5114/aic.2019.86014. Epub 2019 Jun 26. PMID: 31497054; PMCID: PMC6727232.

Çelik, F, Tüfek A, Yıldırım ZB, Karaman H, Baykan H, Kavak GÖ, et al. İleri derece yaşlı hastada mini doz bupivakain ile spinal anestezi. J Clin Exp Invest. 2014;1(3):214-5.

Turrentine FE, Wang H, Simpson VB, Jones RS. Surgical risk factors, morbidity, and mortality in elderly patients. J Am Coll Surg. 2006 Dec;203(6):865-77. doi: 10.1016/j.jamcollsurg.2006.08.026. PMID: 17116555.

Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-83. doi: 10.1016/0021-9681(87)90171-8. PMID: 3558716.

Wanebo HJ, Cole B, Chung M, Vezeridis M, Schepps B, Fulton J, et al. Is surgical management compromised in elderly patients with breast cancer? Ann Surg. 1997 May;225(5):579-86; discussion 586-9. doi: 10.1097/00000658-199705000-00014. PMID: 9193185; PMCID: PMC1190799.

Bugeja G, Kumar A, Banerjee AK. Exclusion of elderly people from clinical research: a descriptive study of published reports. BMJ. 1997 Oct 25;315(7115):1059. doi: 10.1136/bmj.315.7115.1059. PMID: 9366735; PMCID: PMC2127695.

Speziale G, Nasso G, Barattoni MC, Esposito G, Popoff G, Argano V, et al. Short-term and long-term results of cardiac surgery in elderly and very elderly patients. J Thorac Cardiovasc Surg. 2011 Mar;141(3):725-31, 731.e1. doi: 10.1016/j.jtcvs.2010.05.010. Epub 2010 Jun 19. PMID: 20646718.

Yorgancioğlu, et al. İleri yaş grubunda koroner bypass deneyimi. 5. Ulusal Göğüs Kalp ve Damar Cerrahisi Kongresi, 20-24 Ekim 1998 Antalya

Roques F, Nashef SA, Michel P, Gauducheau E, de Vincentiis C, Baudet E, et al. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg. 1999 Jun;15(6):816-22; discussion 822-3. doi: 10.1016/s1010-7940(99)00106-2. PMID: 10431864.

Mullany CJ, Mock MB, Brooks MM, Kelsey SF, Keller NM, Sutton-Tyrrell K, et al. Effect of age in the Bypass Angioplasty Revascularization Investigation (BARI) randomized trial. Ann Thorac Surg. 1999 Feb;67(2):396-403. doi: 10.1016/s0003-4975(98)01191-6. PMID: 10197660.

Kouchoukos NT, Oberman A, Kirklin JW, Russell RO Jr, Karp RB, Pacifico AD, et al. Coronary bypass surgery: analysis of factors affecting hospital mortality. Circulation. 1980 Aug;62(2 Pt 2):I84-9. PMID: 6967378.

Brawley RK, Merrill W, Gott VL, Donahoo JS, Watkins L Jr, Gardner TJ. Unstable angina pectoris. Factors influencing operative risk. Ann Surg. 1980 Jun;191(6):745-50. doi: 10.1097/00000658-198006000-00013. PMID: 6966911; PMCID: PMC1344788.

Cosgrove DM, Loop FD, Lytle BW, Baillot R, Gill CC, Golding LA, et al. Primary myocardial revascularization. Trends in surgical mortality. J Thorac Cardiovasc Surg. 1984 Nov;88(5 Pt 1):673-84. PMID: 6492837.

Edmunds LH Jr, Stephenson LW, Edie RN, Ratcliffe MB. Open-heart surgery in octogenarians. N Engl J Med. 1988 Jul 21;319(3):131-6. doi: 10.1056/NEJM198807213190302. PMID: 3386692.

Katz NM, Hannan RL, Hopkins RA, Wallace RB. Cardiac operations in patients aged 70 years and over: mortality, length of stay, and hospital charge. Ann Thorac Surg. 1995 Jul;60(1):96-100; discussion 100-1. PMID: 7598628.

Alexander KP, Anstrom KJ, Muhlbaier LH, Grosswald RD, Smith PK, Jones RH, et al. Outcomes of cardiac surgery in patients > or = 80 years: results from the National Cardiovascular Network. J Am Coll Cardiol. 2000 Mar 1;35(3):731-8. doi: 10.1016/s0735-1097(99)00606-3. PMID: 10716477.

Parsonnet V. Risk stratification in cardiac surgery: is it worthwhile? J Card Surg. 1995 Nov;10(6):690-8. doi: 10.1111/j.1540-8191.1995.tb00659.x. PMID: 8574027.

Akins CW, Daggett WM, Vlahakes GJ, Hilgenberg AD, Torchiana DF, Madsen JC, et al. Cardiac operations in patients 80 years old and older. Ann Thorac Surg. 1997 Sep;64(3):606-14; discussion 614-5. doi: 10.1016/s0003-4975(97)00615-2. PMID: 9307446.

Downloads

Published

2020-06-01

Issue

Section

Research Article

How to Cite

1.
Kartal H, Sicim H, Mungan U, Demirdaş E, Erol G, Ocal A, Koç M. Assessment of preoperative risk scoring systems in geriatric and non-geriatric coronary bypass surgery patients. J Surg Med [Internet]. 2020 Jun. 1 [cited 2024 Dec. 13];4(6):491-5. Available from: https://jsurgmed.com/article/view/744784