Department of Cardiovascular Surgery, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 61, Third Avenue, TEDA, Tianjin, China.
Department of Cardiovascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
J Cardiothorac Surg. 2023 Feb 1;18(1):53. doi: 10.1186/s13019-023-02163-y.
We aimed to identify in-hospital outcomes in young (≤ 65 years) and old (> 65 years) patients after coronary artery bypass grafting (CABG) by analyzing the effect of age on adverse events after on-pump or off-pump CABG.
Patients older than 65 years were defined as older patients and others were defined as younger patients. The qualitative data were compared by chi-square or Fisher's exact tests. The quantitative data were compared by the two-sample independent t-test or Mann-Whitney U test. Multifactor binary logistic regression was used to control for confounders and to investigate the effect of age on dichotomous outcome variables such as death.
In the on-pump CABG population, the postoperative in-hospital mortality, the incidence of postoperative symptomatic cerebral infarction (POSCI) and postoperative atrial fibrillation (POAF) was higher in older patients than in younger patients (P value < 0.05), and age > 65 years was associated with postoperative in-hospital mortality (OR = 2.370, P value = 0.031), POSCI (OR = 5.033, P value = 0.013), and POAF (OR = 1.499, P value < 0.001). In the off-pump CABG population, the incidence of POAF was higher in older patients than in younger patients (P value < 0.05), and age > 65 years was associated with POAF (OR = 1.392, P value = 0.011).
In-hospital outcomes after CABG are strongly influenced by age. In on-pump CABG, the risk of postoperative death, POSCI, and POAF was higher in older patients, and in off-pump CABG, the risk of POAF was higher in older patients.
通过分析体外循环和非体外循环冠状动脉旁路移植术(CABG)后年龄对不良事件的影响,确定 CABG 术后年轻(≤65 岁)和老年(>65 岁)患者的院内转归。
年龄>65 岁的患者定义为老年患者,其他患者定义为年轻患者。使用卡方检验或 Fisher 确切概率法比较定性数据,使用两独立样本 t 检验或 Mann-Whitney U 检验比较定量数据。多因素二项逻辑回归用于控制混杂因素,并研究年龄对术后院内死亡、术后症状性脑梗死(POSCI)和术后心房颤动(POAF)等二分类结局变量的影响。
在体外循环 CABG 人群中,老年患者术后院内死亡率、术后症状性脑梗死(POSCI)和术后心房颤动(POAF)发生率高于年轻患者(P 值<0.05),年龄>65 岁与术后院内死亡率(OR=2.370,P 值=0.031)、POSCI(OR=5.033,P 值=0.013)和 POAF(OR=1.499,P 值<0.001)相关。在非体外循环 CABG 人群中,老年患者 POAF 发生率高于年轻患者(P 值<0.05),年龄>65 岁与 POAF 相关(OR=1.392,P 值=0.011)。
CABG 术后的院内转归受年龄的强烈影响。在体外循环 CABG 中,老年患者术后死亡、POSCI 和 POAF 的风险更高,而非体外循环 CABG 中,老年患者 POAF 的风险更高。