OBJECTIVES The objective was to review national trends in activity and hospital outcomes in older patients having cardiac surgery over a 15-year time period. METHODS Data were collected prospectively and uploaded to the National Institute for Cardiovascular Outcomes Research electronically. Data were validated, cleaned and processed using reproducible algorithms. Mortality was death in hospital after index operation. RESULTS A total of 227 442 cardiac procedures were recorded in patients aged ≥70 years of which 46 354 were in those aged ≥80 years. Overall patients aged ≥70 years represented 43% of all adult cardiac surgery in the most recent study year. The annual proportion of surgery in patients ≥80 years increased from 4.1% to 10.8% between the first and last study years. There has been a significant linear increase in octogenarian valve [β 67.44, 95% confidence interval (CI) 55.04 to 79.83, P < 0.001] and coronary artery bypass graft surgery (β 32.53, 95% CI 6.16 to 58.90, P = 0.020) patients. In-hospital mortality reduced significantly for patients aged 70–79 years (β −0.17, 95% CI −0.20 to −0.13, P < 0.001) and all patients aged ≥80 (β −0.37, 95% CI −0.45 to −0.30, P < 0.001). The median length of hospital stay was 7 days for 70–79 and 9 days for ≥80 group, compared with 7 days for the whole cohort <70 years. CONCLUSIONS This study represents the largest complete validated national dataset of cardiac surgery in the entire population of older patients. Octogenarians represent 11% of adult patients having cardiac surgery by the end of the study period, a three-fold increase from the start. In-hospital mortality in patients aged ≥80 years halved during study period to only 4% despite high logistic EuroSCORE of 15%. Cardiac surgery in octogenarians places a higher demand on resources, however, with an increased postoperative length of stay.

中文翻译：

---

老年患者的心脏手术：来自完整的国家系列的 15 年期间的医院结果

目的 目的是审查 15 年期间接受心脏手术的老年患者的活动和住院结局的全国趋势。方法 前瞻性收集数据并以电子方式上传至美国国家心血管结局研究所。使用可重现的算法验证、清理和处理数据。死亡率为指数手术后住院死亡。结果 ≥70 岁的患者共进行了 227 442 例心脏手术，其中 46 354 例为≥80 岁的患者。在最近的研究年度中，年龄≥70 岁的总体患者占所有成人心脏手术的 43%。在第一个研究年和最后一个研究年之间，≥80 岁患者的年度手术比例从 4.1% 增加到 10.8%。八十多岁的瓣膜 [β 67. 44, 95% 置信区间 (CI) 55.04 至 79.83, P < 0.001] 和冠状动脉旁路移植手术 (β 32.53, 95% CI 6.16 to 58.90, P = 0.020) 患者。70-79 岁患者的住院死亡率显着降低（β -0.17, 95% CI -0.20 至 -0.13, P < 0.001）和所有年龄≥80 岁的患者（β -0.37, 95% CI -0.45 至 - 0.30，P＜0.001)。70-79 岁组的中位住院时间为 7 天，≥80 岁组为 9 天，而整个队列<70 岁的中位住院时间为 7 天。结论 本研究代表了整个老年患者群体中最大的、经过验证的、完整的全国心脏手术数据集。到研究期结束时，八十多岁的人占接受心脏手术的成年患者的 11%，比开始时增加了三倍。尽管逻辑 EuroSCORE 高达 15%，但 80 岁以上患者的住院死亡率在研究期间减半至仅 4%。然而，八十多岁的心脏手术对资源的需求更高，术后住院时间也更长。