302 Is Age Just A Number in Cardiac Surgery? Evaluating Outcomes of An Octogenarian Cohort at A Single Cardiac Centre

Introduction Cardiac surgery in octogenarians contains many age-specific perioperative risk factors and outcomes yet to be fully understood. Method All adults (N = 4957) undergoing cardiac surgery between 2011-2017 at our institution were retrospectively studied, encompassing 312 octogenarians. Data was evaluated with univariate and multivariate testing and mortality with Kaplan-Meier and cox-regression analyses. Results Compared to septuagenarians, octogenarians revealed more patients having previous surgery (p = 0.016), less diabetic patients (p = 0.034), lower BMI (0.002), and longer hospital stay (p < 0.000). Compared to rest of study, octogenarians contained more females (p = 0.012), a greater Euroscore (p < 0.000), spent longer in ITU (p = 0.001) and contained more ITU readmissions (p = 0.023). The octogenarians did not contain significant 30- and 90-day mortality but revealed significant mortality at 1-year versus septuagenarians (p = 0.039) and rest of study (p = 0.001). Variables testing significant in a multivariate regression were inserted into a cox-regression that found octogenarian group-membership to be insignificant (p = 0.051) in a 12-covariate model. Independent risk factors for mortality included emergency surgery (p = 0.04), reoperation (p < 0.000), cardiac procedure (p = 0.007), ITU time (p = 0.041) and diabetes (p = 0.023). Conclusions We report specific differences for octogenarians in perioperative characteristics along with promising short- and medium-term survival. Such outcomes must constantly be monitored so that cardiac surgery can be further tailored to this elderly cohort.

Outcomes of Acute Aortic Dissection Surgery in Octogenarians

Background Octogenarians (≥80 years old) are high‐risk patients for acute aortic dissection (AAD) surgery. However, no population‐based study has investigated the late outcomes of AAD surgery in octogenarians. This study aimed to investigate the late outcomes of AAD surgery in octogenarians. Methods and Results A total of 3998 patients who received AAD surgery from 2005 to 2013 were identified from the Taiwan National Health Insurance Research Database. In‐hospital complications and late outcomes including all‐cause mortality, major adverse cardiac and cerebrovascular event, respiratory failure, and redo aortic surgery were evaluated. The risks of late outcomes between octogenarians and nonoctogenarians were compared using the multivariable Cox proportional hazard model or Fine and Gray competing model. The numbers of the octogenarians who underwent type A and B AAD surgeries were 206 (6%; 206/3423) and 79 (13.7%; 79/575), respectively. Compared with the nonoctogenarians, the type A octogenarians had higher risks of in‐hospital mortality and several in‐hospital complications, whereas the type B octogenarians did not. Furthermore, compared with the nonoctogenarians, the type A octogenarians had a higher risk of all‐cause mortality (61.7% vs 32.5%; hazard ratio [HR], 2.35; 95% CI, 1.95–2.84) and a higher cumulative incidence of major adverse cardiac and cerebrovascular event and respiratory failure, and the type B octogenarians demonstrated a higher risk of all‐cause mortality (44.3% vs 30.4%; HR, 1.74; 95% CI, 1.18–2.55). The octogenarians receiving AAD surgeries had higher mortality rates than the normal octogenarian population. Conclusions Octogenarians receiving AAD surgeries exhibit worse late outcomes than nonoctogenarian counterparts.