Division of Cardiac Surgery, Royal Victoria Hospital, Montreal, Quebec, Canada.
Ann Thorac Surg. 2010 Mar;89(3):805-10. doi: 10.1016/j.athoracsur.2009.12.002.
A prospective study of survival, functional outcome, living arrangements, daily activities and leisure engagements among octogenarians up to 5 years after cardiac surgery was performed.
The study consisted of a cohort of 300 consecutive octogenarians with three interviews made at 6-month intervals for a total of 593 postoperative interviews. Functional outcomes were measured using the Barthel index and Karnofsky performance scores and divided into autonomous, semiautonomous, or dependent. Living arrangements and leisure activities within the social, physical, cognitive, and creative domains were recorded in an open-ended questionnaire.
There were 150 men and 150 women with a mean age 82.6 years. The 30-day survival was 84.3%. Actuarial survival at 1, 3, and 5 years was 76.6%, 66.6%, and 57.8%, respectively. Among the survivors at the first interview, 2.2 years postoperatively, there were 63.9% autonomous, 31.7% semiautonomous, and 4.3% dependent patients versus at the last interview, 3.6 years postoperatively, in which there were 64.9% autonomous, 28.1% semiautonomous, and 9.2% dependent. At the first interview, 76.4% were at home, 19.2 % in a residence, and 4.3% in a supervised setting. At the third interview, 71.8% were at home, 21.2% in a residence, and 6.9% in a supervised setting. Nearly all patients were involved in leisure activities in the social (98.9%), cognitive (98.4%), and physical (93.1%) domains. At the end of the last interview, activities within the social and cognitive domains were maintained with a small decrease in the physical domain.
Surviving octogenarians remain at home, function independently, and engage in regular leisure activities years after cardiac surgery. This information might help physicians and surgeons regarding long-term outcome of open cardiac surgery in octogenarians.
对 300 例 80 岁以上患者进行了前瞻性研究，以评估他们在心脏手术后 5 年内的生存、功能结局、生活安排、日常活动和休闲活动。
该研究包括一个队列，共 300 例连续 80 岁以上患者，在 6 个月时进行了 3 次随访，共进行了 593 次术后随访。采用 Barthel 指数和 Karnofsky 功能评分评估功能结局，并分为自主、半自主或依赖。通过开放式问卷记录社会、身体、认知和创造领域的生活安排和休闲活动。
男性 150 例，女性 150 例，平均年龄 82.6 岁。30 天生存率为 84.3%。术后 1、3 和 5 年的生存率分别为 76.6%、66.6%和 57.8%。在第一次随访（术后 2.2 年）时，存活患者中自主患者占 63.9%，半自主患者占 31.7%，依赖患者占 4.3%；而在最后一次随访（术后 3.6 年）时，自主患者占 64.9%，半自主患者占 28.1%，依赖患者占 9.2%。第一次随访时，76.4%的患者在家中，19.2%的患者居住在养老院，4.3%的患者居住在监护病房。第三次随访时，71.8%的患者在家中，21.2%的患者居住在养老院，6.9%的患者居住在监护病房。几乎所有患者都参与了社会（98.9%）、认知（98.4%）和身体（93.1%）领域的休闲活动。在最后一次随访结束时，社会和认知领域的活动得到了维持，身体活动略有减少。
心脏手术后数年，存活的 80 岁以上患者仍在家中生活，独立生活，并定期进行休闲活动。这些信息可能有助于医生和外科医生了解高龄患者心脏手术的长期效果。
