Perioperative determinants of morbidity and mortality in elderly patients undergoing cardiac surgery

Critical Care Medicine

Volumn 26, Issue 2, 1998, Pages 225-235

  Rady, Mohamed Y ^a,b   Ryan, Thomas ^a   Starr, Norman J ^a  

^a LERNER RESEARCH INSTITUTE   (United States)

^b MAYO CLINIC   (United States)

Author keywords

Anemia; Cardiac surgery; Elderly patients; Hyperglycemia; Morbidity; Mortality; Myocardial dysfunction; Predictors; Resource utilization; Splanchnic ischemia

Indexed keywords

ALBUMIN; BILIRUBIN; GLUCOSE; HYPERTENSIVE FACTOR; INOTROPIC AGENT;

AGED; ANEMIA; ARTICLE; ARTIFICIAL VENTILATION; BLEEDING; BLOOD TRANSFUSION; CARDIOPULMONARY BYPASS; CONTROLLED STUDY; ELDERLY CARE; FEMALE; HEART SURGERY; HOSPITAL INFECTION; HUMAN; INTENSIVE CARE UNIT; MAJOR CLINICAL STUDY; MALE; MORBIDITY; MORTALITY; MYOCARDIAL DISEASE; PATIENT SELECTION; PERIOPERATIVE PERIOD; PREDICTION; PRIORITY JOURNAL; RESOURCE MANAGEMENT; SURGICAL MORTALITY; SURGICAL TECHNIQUE; TREATMENT OUTCOME;

AGED; CARDIAC SURGICAL PROCEDURES; COHORT STUDIES; EMERGENCIES; FEMALE; HUMANS; INCIDENCE; INTENSIVE CARE; MALE; POSTOPERATIVE COMPLICATIONS; PROGNOSIS; REOPERATION; RISK FACTORS; STATISTICS; SURGICAL PROCEDURES, ELECTIVE; TREATMENT OUTCOME;

EID: 0031943912     PISSN: 00903493     EISSN: None     Source Type: Journal    
DOI: 10.1097/00003246-199802000-00016     Document Type: Article

References (35)

1. Martin L: Population aging policies in East Asia and the United States. Science 1991; 251:527-532
2. Rowe JW, Grossman E, Bond E: Academic geriatrics for the year 2000: An institute of medicine report. N Engl J Med 1987; 316:1425-1428
3. Gresh PJ, Kronmal RA, Fire RL, et al: Coronary arteriography and coronary artery bypass surgery. Mortality and morbidity in patients aged 65 years and older. A report from the Coronary Artery Surgery Study. Circulation 1983; 67:483-491
4. Mullamy CJ, Darling GE, Pluth JR, et al: Early and late results after isolated coronary artery bypass surgery in 159 patients aged 80 years and older. Circulation 1990; 82:229-236
5. Parry AJ, Giannopolous N, Ormerod O, et al: An audit of cardiac surgery in patients aged over 70 years. QJM 1994; 87:89-96
6. Parsonnet V, Dean D, Bersteom AD: A method of uniform stratification of risk for evaluating the results of surgery in acquired adult heart disease. Circulation 1990; 79(6, part 2):13-20
7. Higgins TL, Estafanous FG, Loop FD, et al: Stratification of morbidity and mortality outcome by preoperative risk factors in coronary artery bypass patients. JAMA 1992; 267:2344-2348
8. Tuman KJ, McCarthy RJ, March RJ, et al: Morbidity and duration of ICU stay after cardiac surgery: A model for preoperative risk assessment. Chest 1992; 102:36-44
9. Consensus Conference of the ESICM and the SRLF: Predicting outcome in ICU patients. Intensive Care Med 1994; 20:390-397
10. McClish DK, Powell SH, Montenegro H, et al: The impact of age on utilization of intensive care resources. J Am Geriatrics Society 1987; 35:983-988
11. Holmes L, Loughead K, Treasure T, et al: Which patients will not benefit from further intensive care after cardiac surgery? Lancet 1994; 344:1200-1202
12. Horvath KA, DiSesa VJ, Peigh PS, et al: Favorable results of coronary artery bypass grafting in patients older than 75 years. J Thorac Cardiovasc Surg 1990;99:92-96
13. Edwards FH, Taylor AJ, Thompson L, et al: Current status of coronary artery operation in septuagenerians. Ann Thorac Surg 1991; 52:265-269
14. Freeman WK, Schaff HV, O'Brien PC, et al: Cardiac surgery in the octogenarian: Perioperative outcome and clinical follow-up. J Am Coll Cardiol 1991; 18:25-29
15. Bernard GR, Doig G, Hudson LD, et al: Quantification of organ failure for clinical trials and clinical practice. Abstr. Am J Respir Crit Care Med 1995; 151: A323
16. Hammermeister KE, Burchfiel C, Johnson R, et al: Identification of patients at greatest risk for developing major complications at cardiac surgery. Circulation 1990; 82(Suppl IV): IV380-IV389
17. Pifarre R: Open heart operations in the elderly: Changing risk parameters. Ann Thorac Surg 1993; 56:S71-S73
18. Walsh ES, Paterson JL, O'Riordan JB, et al: Effect of high-dose fentanyl anesthesia on the metabolic and endocrine response to cardiac surgery. Br J Anaesth 1981; 53:1155-1165
19. Riddington DW, Venkatesh B, Boivin CM, et al: Intestinal permeability, gastric intramucosal pH, and systemic endotoxemia in patients undergoing cardiopulmonary bypass. JAMA 1996; 275:1007-1012
20. Auden J, Bernstein WK, Khastgir T, et al: The use and clinical importance of a substrate-specific electrode for rapid determination of blood lactate concentrations. JAMA 1994; 272:1678-1685
21. Casey LC: Role of cytokines in the pathogenesis of cardiopulmonary-induced multi-system organ failure. Ann Thorac Surg 1993; 56:S92-S96
22. Landow L: Splanchnic lactate production in cardiac surgery patients. Crit Care Med 1993; 21:S84-S91
23. Deehan DJ, Keys SD, Simpson W, et al: Correlation of serum cytokine and acute phase reactant levels with alterations in weight and serum albumin in patients receiving immunotherapy with recombinant IL-2 . Clin Exp Immunol 1994; 95:366-372
24. American Society of Anesthesiologists Task Force on Blood Component Therapy: Practice guidelines for blood component therapy. Anesthesiology 1996; 84:732-747
25. Hebert PC, Wells G, Marshall J, et al: Transfusion requirements in critical care, a pilot study. JAMA 1995; 273:1439-1444
26. Spahn DR, Zollinger A, Schlumpf RB, et al: Hemodilution tolerance in elderly patients without known cardiac disease. Anesth Analg 1996; 82:681-686
27. Spahn DR, Schmid ER, Siefert B, et al: Hemodilution tolerance in patients with coronary artery disease who are receiving chronic β-adrenergic blocker therapy. Anesth Analg 1996; 82:687-694
28. Morisaki H, Sibbald W, Martin C, et al: Hyperdynamic sepsis depresses circulatory compensation to normovolemic anemia in conscious rats. J Appl Physiol 1996; 80:656-664
29. Levy PS, Quigley RL, Gould SA: Acute dilutional anemia and critical left anterior descending coronary artery stenosis impairs end organ oxygen delivery. J Trauma 1996; 41:416-423
30. Baue AE: The role of the gut in the development of multiple organ dysfunction in cardio-thoracic patients. Ann Thorac Surg 1993; 55:822-829
31. Mythen MG, Webb AR: Perioperative plasma volume expansion reduces the incidence of gut mucosal hypoperfusion during cardiac surgery. Arch Surg 1995; 130:423-429
32. Uusaro A, Ruokonen E, Takala J: Splanchnic oxygen transport after cardiac surgery: Evidence for inadequate tissue perfusion after stabilization of hemodynamics. Intensive Care Med 1996; 22:26-33
33. Mayer-Oakes SA, Oye RK, Leake B: Predictors of mortality in older patients following medical intensive care: The importance of functional status. J Am Geriatr Soc 1991; 39:862-868
34. Pesau B, Falger S, Berger E, et al: Influence of age on outcome of mechanically ventilated patients in an intensive care unit. Crit Care Med 1992; 20: 489-492
35. Cohen IL, Lambrinos J, Fein IA: Mechanical ventilation for the elderly patient in intensive care: Incremental charges and benefits. JAMA 1993; 269: 1025-1029