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Age 75 years is associated with greater resource utilization following coronary artery bypass grafting

^a The Heart Hospital, University College London Hospitals NHS Foundation Trust, 16–18 Westmoreland Street, London W1G 8PH, UK
^b Barnet Hospital, Wellhouse Lane, Barnet, Herts EN5 3DJ, UK

*Corresponding author. Tel.: +44 20 7504 8942; fax: +44 20 7504 8943.

E-mail address: john.yap{at}uclh.nhs.uk (J. Yap).

We examined whether complication rates and resource utilization among elderly patients undergoing coronary artery bypass grafting (CABG) differed from their younger counterparts. A retrospective review of prospectively collected data was conducted of 2936 patients undergoing first-time isolated CABG. Demographic and baseline clinical characteristics were collected, and patients grouped according to age into those <75 years (n=2424, younger) and 75 years (n=512, older). Major postoperative complications were recorded and data collected on indicators of resource utilization, which included intensive care unit (ICU) length of stay (LOS), postoperative LOS and total hospital LOS. In comparison with younger patients, older patients were more likely to be female (26.6% vs. 18.1%, P<0.0001) and require an urgent procedure (46.4% vs. 33.3%, P<0.0001). Postoperative complications were significantly higher in elderly patients (43.7% vs. 23.0%; odds ratio (OR)=2.5, 95% confidence interval (CI) [2.0–3.1]; P<0.0001). Older patients incurred longer intensive care stays (2 days interquartile range (IQR) [1–3] vs. 1 day IQR [1–2]; P<0.0001) and a longer postoperative stay (8 days IQR [6–11] vs. 6 days IQR [5–8]; P<0.0001). Multivariate logistic regression analysis showed age 75 years was an independent predictor of postoperative LOS (OR=1.23, 95% CI [0.49–1.96]; P=0.001). Older patients aged 75 years undergoing CABG had significantly higher rates of postoperative complications and greater resource utilization than their younger counterparts.

Key Words: Coronary artery bypass grafting; Elderly; Length of stay