New approaches to risk stratification in elderly patients with heart surgery
Abstract
The problem of risk stratification in elderly patients undergoing elective cardiac surgery is still quite acute.
Aim – to analyze perioperative predictors of 30-day mortality in elective elderly cardiosurgical patients and to develop, on this results, original risk stratification models.
Material and methods. Our study included 127 patients (87 male and 40 female) in the age from 65 to 84 years (mean age 72.2±4.7 years). A wide range of perioperative factors was analyzed. The primary end point of the study was a 30-day mortality.
Results. Statistically significant perioperative predictors of the 30-day mortality were: the calculated values of the CAF scale (p<0.001) and EFI scale (p=0.001), the operation volume (p=0.044), the use of CPB during surgery (p=0.048). Based on frailty scale used in our study and positive predictors of 30-day mortality original scales were developed and compared with EuroScore II scale (p=0.676). Original scales had high prognostic value: original scale based on CAF (p<0.001); original scale based on EFI (p<0.001).
Conclusion. Using of frailty scores and based on it original models allows you to accurately predict 30-day mortality in elderly patients.
Keywords:cardiac surgery, surgery, aging, frailty index
For citation: Shikhverdiev N.N., Ushakov D.I., Peleshok A.S., Krivopalov V.A., Sizenko V.V. New approaches to risk stratification in elderly patients with heart surgery. Clin Experiment Surg. Petrovsky J. 2019; 7 (1): 27–7. doi: 10.24411/2308-1198- 2019-11003. (in Russian)
Received 27.06.2018. Accepted 06.02.2019.
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