Cloin E C W, Noyez L
Neth Heart J. 2005 Apr;13(4):132-138.
Are elderly patients now undergoing CABG at higher risk than several years ago?
1536 patients, aged between 70 and 77 years, who underwent CABG between January 1987 and December 2001, were analysed. Group A 1987-1989 (n=177); group B 1990-1992 (n=243); group C 1993-1995 (n=362); group D 1996-1998 (n=418); and group E 1999-2001 (n=336). The Euroscore evaluated operative risk.
There was an increase in the percentage of the study population from 12.5 to 24.1% (p=0.000). Mean age increased from 72.1±1.8 to 73.2±1.9 years (p=0.047). The percentage of patients with neurological (p=0.002), renal (p=0.013) and lung disease (p=0.04), a previous PTCA (p=0.000), left main stenosis (p=0.003), impaired ventricular function (p=0.000) and reoperations (p=0.01) increased. Emergency/urgent operations (p=0.001) decreased. Hospital mortality decreased from 7.3 to 5.7% (p=0.34). Only neurological problems increased significantly (p=0.03). The calculated operative risk by Euroscore remained stable (p=0.28). To eliminate the influence of the urgent/emergency situation, the Euroscore was recalculated, supposing that all patients were elective. At that moment a significant increase in the operative risk was seen (p=0.02).
Over the last few years there has not only been an increase in the number of older patients undergoing CABG, but even in this older population there is an increasing number of high-risk patients.
与几年前相比，目前接受冠状动脉旁路移植术（CABG）的老年患者风险是否更高？
对1987年1月至2001年12月期间接受CABG的1536例年龄在70至77岁之间的患者进行分析。A组1987 - 1989年（n = 177）；B组1990 - 1992年（n = 243）；C组1993 - 1995年（n = 362）；D组1996 - 1998年（n = 418）；E组1999 - 2001年（n = 336）。采用欧洲心脏手术风险评估系统（Euroscore）评估手术风险。
研究人群的比例从12.5%增加到24.1%（p = 0.000）。平均年龄从72.1±1.8岁增加到73.2±1.9岁（p = 0.047）。患有神经疾病（p = 0.002）、肾脏疾病（p = 0.013）和肺部疾病（p = 0.04）、既往接受经皮冠状动脉腔内血管成形术（PTCA）（p = 0.000）、左主干狭窄（p = 0.003）、心室功能受损（p = 0.000）及再次手术（p = 0.01）的患者比例增加。急诊/紧急手术（p = 0.001）减少。医院死亡率从7.3%降至5.7%（p = 0.34）。只有神经问题显著增加（p = 0.03）。Euroscore计算出的手术风险保持稳定（p =
