{"id":3428,"date":"1998-02-24T00:00:00","date_gmt":"1998-02-24T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/fifteen-year-trends-in-risk-severity-and-operative-mortality-in-elderly-patients-undergoing-coronary-artery-bypass-graft-surgery\/"},"modified":"2023-06-14T19:46:37","modified_gmt":"2023-06-14T23:46:37","slug":"fifteen-year-trends-in-risk-severity-and-operative-mortality-in-elderly-patients-undergoing-coronary-artery-bypass-graft-surgery","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/fifteen-year-trends-in-risk-severity-and-operative-mortality-in-elderly-patients-undergoing-coronary-artery-bypass-graft-surgery\/","title":{"rendered":"Fifteen-year trends in risk severity and operative mortality in elderly patients undergoing coronary artery bypass graft surgery"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; Trends in risk-severity and operative mortality (OM) were examined in 3330 consecutive patients aged 70 years and older who underwent isolated coronary artery bypass graft surgery (CABG) between 1982 and 1996.<\/p>\n<p><span class=\"bold\">Methods and Results<\/span> &#x2014; The proportion of elderly patients rose significantly over time (P&lt;.001). Crude OM among the elderly was 7.2% in 1982 to 1986, fell to 4.4% in 1987 to 1991, but did not improve thereafter. Logistic regression analysis of OM was used to construct relative risk groups (low, medium, or high). The prevalence of high-risk elderly patients rose significantly over time (P=.001) from 16.2% in 1982 to 1986 to 19.5% in 1987 to 1991 and 26.9% in 1992 to 1996. OM in high-risk patients fell significantly (P=.044) from 17.2% in 1982 to 1986 to 9.1% in 1987 to 1991 and was 8.9% in 1992 to 1996. Contemporary independent predictors of OM among elderly patients were poor ventricular function (LV grade 2 to 3, odds ratio [OR], 2.6; 95% confidence interval [CI], 1.3 to 5.2; and LV grade 4, OR, 10.7; 95% CI, 4.4 to 26); previous CABG (OR, 3.7; 95% CI, 2.0 to 7.0), female sex (OR, 1.8; 95% CI, 1.1 to 2.8), peripheral vascular disease (OR, 1.8; 95% CI, 1.1 to 2.8), and diabetes (OR, 1.7; 95% CI, 1.1 to 2.7). Previous angioplasty was protective (OR, 0.3; 95% CI, 0.1 to 0.9).<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; OM in elderly patients has declined significantly in recent years despite an increase in the prevalence and severity of their risk factors. A careful weighing of risk, rather than advanced age alone, should determine who is offered surgical revascularization. In this regard, poor ventricular function and repeat CABG continue to have the greatest impact on OM in elderly patients. <\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; Trends in risk-severity and operative mortality (OM) were examined in 3330 consecutive patients aged 70 years and older who underwent isolated coronary artery bypass graft surgery (CABG) between 1982 and 1996. Methods and Results &#x2014; The proportion of elderly patients rose significantly over time (P&lt;.001). Crude OM among the elderly was 7.2% in [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[40,62,25],"migration-helper-qa-sample-set":[],"class_list":["post-3428","journal_article","type-journal_article","status-publish","hentry","topic-cardiovascular-disease","topic-health-services-research","topic-surgery"],"acf":{"citation":"Ivanov J, Weisel RD, David TE, Naylor CD. <em>Circulation<\/em>. 1998; 97(7):673-80.","source_url":"http:\/\/circ.ahajournals.org\/content\/97\/7\/673.long","ices_scientist":[1304],"site":[6733],"research_program":[6742],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"31A2D71D-608F-4A09-B9EA-825DF841AE88","sitecore_item_name":"Fifteen-year-trends-in-risk-severity-and-operative-mortality-in-elderly-patients-undergoing-coronary","sitecore_field_values":"{\n  \"Title\": \"Fifteen-year trends in risk severity and operative mortality in elderly patients undergoing coronary artery bypass graft surgery\",\n  \"Short title\": \"Fifteen-year trends in risk severity\",\n  \"Citation\": \"<p>Ivanov J, Weisel RD, David TE, Naylor CD. <em>Circulation<\/em>. 1998; 97(7):673-80.<\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; Trends in risk-severity and operative mortality (OM) were examined in 3330 consecutive patients aged 70 years and older who underwent isolated coronary artery bypass graft surgery (CABG) between 1982 and 1996.<\/p>n<p><span class=\"bold\">Methods and Results<\/span> &mdash; The proportion of elderly patients rose significantly over time (P&lt;.001). Crude OM among the elderly was 7.2% in 1982 to 1986, fell to 4.4% in 1987 to 1991, but did not improve thereafter. Logistic regression analysis of OM was used to construct relative risk groups (low, medium, or high). The prevalence of high-risk elderly patients rose significantly over time (P=.001) from 16.2% in 1982 to 1986 to 19.5% in 1987 to 1991 and 26.9% in 1992 to 1996. OM in high-risk patients fell significantly (P=.044) from 17.2% in 1982 to 1986 to 9.1% in 1987 to 1991 and was 8.9% in 1992 to 1996. Contemporary independent predictors of OM among elderly patients were poor ventricular function (LV grade 2 to 3, odds ratio [OR], 2.6; 95% confidence interval [CI], 1.3 to 5.2; and LV grade 4, OR, 10.7; 95% CI, 4.4 to 26); previous CABG (OR, 3.7; 95% CI, 2.0 to 7.0), female sex (OR, 1.8; 95% CI, 1.1 to 2.8), peripheral vascular disease (OR, 1.8; 95% CI, 1.1 to 2.8), and diabetes (OR, 1.7; 95% CI, 1.1 to 2.7). Previous angioplasty was protective (OR, 0.3; 95% CI, 0.1 to 0.9).<\/p>n<p><strong>Conclusions<\/strong> &mdash; OM in elderly patients has declined significantly in recent years despite an increase in the prevalence and severity of their risk factors. A careful weighing of risk, rather than advanced age alone, should determine who is offered surgical revascularization. In this regard, poor ventricular function and repeat CABG continue to have the greatest impact on OM in elderly patients. <\/p>n<p><a href=\"http:\/\/circ.ahajournals.org\/content\/97\/7\/673.long\" title=\"Opens external link\">View full text<\/a><\/p>\",\n  \"Keywords\": \"{92E2791D-5DAB-4244-8A85-434D524D9A12}|{9F514AF9-2526-48FE-8414-54C443CF99AD}|{A39C5396-16B7-4369-B0F9-31F6E91E46FC}\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{545C70EB-0A3F-4646-A0F5-509EB7E15CF6}\",\n  \"Posted Date\": \"19980224T000000\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/1998\/January\/Fifteen-year-trends-in-risk-severity-and-operative-mortality-in-elderly-patients-undergoing-coronary"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Fifteen-year trends in risk severity and operative mortality in elderly patients undergoing coronary artery bypass graft surgery<\/title>\n<meta name=\"description\" content=\"Background &#x2014; Trends in risk-severity and operative mortality (OM) were examined in 3330 consecutive patients aged 70 years and older who underwent\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/fifteen-year-trends-in-risk-severity-and-operative-mortality-in-elderly-patients-undergoing-coronary-artery-bypass-graft-surgery\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Fifteen-year trends in risk severity and operative mortality in elderly patients undergoing coronary artery bypass graft surgery\" \/>\n<meta property=\"og:description\" content=\"Background &#x2014; Trends in risk-severity and operative mortality (OM) were examined in 3330 consecutive patients aged 70 years and older who underwent\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/fifteen-year-trends-in-risk-severity-and-operative-mortality-in-elderly-patients-undergoing-coronary-artery-bypass-graft-surgery\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-14T23:46:37+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/fifteen-year-trends-in-risk-severity-and-operative-mortality-in-elderly-patients-undergoing-coronary-artery-bypass-graft-surgery\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/fifteen-year-trends-in-risk-severity-and-operative-mortality-in-elderly-patients-undergoing-coronary-artery-bypass-graft-surgery\\\/\",\"name\":\"ICES | Fifteen-year trends in risk severity and operative mortality in elderly patients undergoing coronary artery bypass graft surgery\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"1998-02-24T05:00:00+00:00\",\"dateModified\":\"2023-06-14T23:46:37+00:00\",\"description\":\"Background &#x2014; 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