Ballonbehandling og koronar bypasskirurgi hos aeldre. Forekomst, komplikationer og mortalitet 1999-2003
Sammanfattning
Introduction: Persons over 70 years of age are the fastest-growing segment of the population. A major proportion of these elderly have ischemic heart disease and may need treatment. We describe the development of mechanical coronary revascularization in patients aged 70-79 years versus those 80 years of age or older over a five-year period. Materials and methods: During 1999, 2001 and 2003, a total of 774 patients over 70 years of age had coronary angioplasty (PCI) or coronary artery bypass surgery (CABG) performed at Odense University Hospital. The patients were separated according to type of intervention and age: 70-79 versus = 80 years of age. Retrospectively, descriptive characteristics, complication rates and six-month mortality rates were compiled. Results: During the study period, the number of interventions increased from 182 to 374 per year. In the patients = 80 years of age, a tenfold increase in the number of procedures was noted, whereas the frequency in the younger patients was approximately doubled. During the five-year period, the proportion of CABGs performed was stable, but the frequency of PCIs increased by a factor of five. Over time, the number of acute interventions increased. Patients = 80 years of age more frequently had complications than did patients 70-79 years of age. The six-month mortality rate increased throughout the study period and was highest in patients = 80 years of age. Conclusion: During the five-year period from 1999 to 2003, the total number of coronary revascularizations in the elderly increased. The main reason for this was a marked increment in the use of PCIs and a general increase in the use of revascularizations in patients 80 years of age or older. PCI in the elderly is associated with a lower frequency of complications.