OBJECTIVES: Female gender and advanced age are regarded as independent risk factors
for adverse outcomes after isolated coronary artery bypass grafting (CABG). There
is paucity of evidence comparing outcomes of CABG between male and female octogenarians.
We aimed to analyse in-hospital outcomes of isolated CABG in this cohort.METHODS:
All octogenarians that underwent isolated CABG, from January 2000 to October 2017,
were included. A retrospective analysis of a prospectively collected cardiac surgery
database (PATS; Dendrite Clinical Systems, Oxford, UK) was performed. A propensity
score was generated for each patient from a multivariable logistic regression model
based on 25 pre-treatment covariates. A total of 156 matching pairs were derived.RESULTS:
Five hundred and sixty-seven octogenarians underwent isolated CABG. This included
156 females (mean age 82.1 [SD: 0.9]) and 411 males (mean age 82.4 [SD: 2.1 years]).
More males were current smokers (P = 0.002) with renal impairment (P = 0.041), chronic
obstructive pulmonary disease (P = 0.048), history of cerebrovascular accident (P
= 0.039) and peripheral vascular disease (P = 0.027) while more females had New York
Heart Association class 4 (P = 0.02), left ventricular ejection fraction 30-49% (P
= 0.038) and left ventricular ejection fraction <30% (P = 0.049). On-pump, CABG was
performed in 140 males and 52 females (P = 0.921). There was no difference in in-hospital
mortality (5.4% vs 6.4%; P = 0.840), stroke (0.9% vs 1.3%; P = 0.689), need for renal
replacement therapy (17.0% vs 13.5%; P = 0.732), pulmonary complications (9.5% vs
8.3%; P = 0.746) and sternal wound infection (2.7% vs 2.6%; P = 0.882). The outcomes
were comparable for the propensity-matched cohorts.CONCLUSIONS: No gender difference
in outcomes was seen in octogenarians undergoing isolated CABG.
