Cardiac Surgery in Octogenarians and Beyond: Single Center Experience
Bibliographic record
Abstract
Background: Increasing numbers of octogenarians and improvements in surgical techniques and postoperative care have resulted in increasing cardiac operations in this age. The aim is to analyze our experience of cardiac surgery on octogenarians and beyond concerning postoperative morbidities and mortality. Methods: 67 octogenarians and nonagenarians underwent open heart surgery in our hospital between 2001 to 2009 were retrospectively reviewed. Data included baseline preoperative status, intraoperative and perioperative course, and immediate outcomes. Results: The mean age was 86.22 ± 6.1 years. 86.6% patients were males. Symptoms were dyspnea; Class II in 13.4%, Class III in 55.2%, Class IV in 31.4% patients; angina in 82.1%, and CHF in 25.4% patients. The mean EF was 37.8% ± 10. Risk factors include smoking in 52.2%, DM in 37.3%, hypertension in 28.4%, obesity in 25.4%, previous MI in 22.4%, COPD in 17.9%, renal insufficiency in 11.9%, pulmonary hypertension in 7.5%, PVD in 6%, and cerebrovascular disease in 3% patients. The procedures were isolated CABG in 73%, AVR in 9%, MVR in 6%, CABG/valve in 9%, and MVR and AVR in 3% patients. Complications were 18%. It included renal impairment in 18%, arrhythmias in 14.9%, bleeding in 6%, prolonged ventilation in 13.4%, CHF in 4.5%, gastrointestinal bleeding in 4.5%, wound infection in 7.5%, and cerebrovascular accident in 3%. Hospital mortality was 9% patients. Conclusions: Cardiac surgery can be performed safely with acceptable hospital morbidity and mortality in octogenarians and beyond. Early referral and proper selection of patients are mandatory to improve immediate postoperative survival.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".