Abstract 14637: Influence of Age on Perioperative Major Adverse Cardiovascular Events and Mortality Risks in Elective Non-cardiac Surgery
Background and Aims: Advanced age increases risk of perioperative cardiovascular complications and might therefore pose reluctance to subject elderly patients to surgery. We examined the impact of high age on perioperative major adverse cardiovascular events (MACE) and mortality in a nationwide cohort of patients undergoing elective surgery.
Methods: All Danish patients aged ≥20 years undergoing non-cardiac, elective surgery in 2005-2011 were identified from nationwide administrative registers. Risks of 30-day MACE (non-fatal ischemic stroke, non-fatal myocardial infarction, or cardiovascular death) and all-cause mortality were analysed by multivariable logistic regression models (adjusted for major comorbidities, revised cardiac risk index, cardiovascular pharmacotherapy, body mass index, and surgery type).
Results: A total of 386,818 procedures were included; mean age 56 years (min-max 20-104), 44% women. In total 1,297 (0.34%) had perioperative MACE and 1,449 (0.37%) died. Odds ratios increased with higher age for both MACE and mortality (Figure). Each 10-year higher age was associated with odds ratio 1.87 (1.78-1.98) for MACE, and 1.86 (1.77-1.95) for mortality. In total of 19,849 procedures were performed in patients 81-90 years of age, and 1,662 on patients ≥90 years. The crude MACE and mortality rates were 331 (1.7%) and 388 (2.0%) among 81-90 years old, and 50 (3.0%) and 67 (4.6%) for those aged ≥90 years.
Conclusion: The risk of mortality and major adverse cardiovascular events within 30 days after surgery increased linearly with advanced age. However, despite advanced age the absolute event rates were relatively modest and below 5% even for people aged ≥90 years.
Author Disclosures: P.W. Hansen: None. G.H. Gislason: None. M. Joergensen: None. L. Køber: None. P.F. Jensen: None. C. Torp-Pedersen: None. C. Andersson: None.
- © 2014 by American Heart Association, Inc.