Elderly discharged home do well after heart valve surgery

Linda Henry, Ph.D., R.N., of the Inova Heart and Vascular Institute in Falls Church, Va., and colleagues examined the variables affecting patient discharge disposition and whether disposition correlated with long-term outcomes in a study involving 307 patients 80 years or older (mean age, 82.9 years) who underwent aortic or mitral valve surgery from 2002 to 2010.

The researchers found that older, unmarried patients with at least one major complication were significantly more likely to not be discharged home after valve surgery. Cumulative survival was significantly lower at one-year (85.8 versus 94.6 percent) and two-years (80.1 versus 90.3 percent) for those not discharged home. On multivariable analysis, patients not discharged home had significantly poorer one- and two-year survival (hazard ratio, 2.56 and 2.06, respectively). For those not discharged home, significant predictors of increased mortality included length of stay and any major complication, with lower body mass index marginally significant.

"Overall, octogenarians can expect excellent survival after valve surgery," the authors write. "However, we found that patients not discharged home after surgery did not experience as robust of outcomes as those patients discharged to home."

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Journal reference: Annals of Thoracic Surgery

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