What Exactly Makes Age a Risk Factor for an Unfavorable Outcome after Mitral Valve Surgery?
Objective: Age has an undeniable impact on perioperative mortality. However, it is not necessarily a predictor of frailty per se, as older patients have different outcomes. To verify specific conditions underlying frailty, we examined demographics, comorbidities, frequency, and distribution of posto...
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| Format: | Article |
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MDPI AG
2022-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/23/6907 |
| _version_ | 1797462944452182016 |
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| author | Roya Ostovar Filip Schröter Ralf-Uwe Kühnel Martin Hartrumpf Johannes Maximilian Albes |
| author_facet | Roya Ostovar Filip Schröter Ralf-Uwe Kühnel Martin Hartrumpf Johannes Maximilian Albes |
| author_sort | Roya Ostovar |
| collection | DOAJ |
| description | Objective: Age has an undeniable impact on perioperative mortality. However, it is not necessarily a predictor of frailty per se, as older patients have different outcomes. To verify specific conditions underlying frailty, we examined demographics, comorbidities, frequency, and distribution of postoperative complications influencing outcomes in a challenging cohort of patients undergoing mitral valve surgery. Methods: The study enrolled 1627 patients who underwent mitral valve surgery. Patients younger than 40 years who had been diagnosed with endocarditis were excluded. Patients were divided into three groups with ages ranging from 40–59 (<i>n</i> = 319), 60–74 (<i>n</i> = 795), and >75 years (<i>n</i> = 513). Baseline, comorbidities, postoperative complications, and mortality were recorded. Results: The older the patients were, the more frequently they suffered from pre- and postoperative renal insufficiency (<i>p</i> < 0.001). The likelihood of postoperative renal failure requiring dialysis was significantly higher with pre-existing renal failure. There was a significant association between postoperative renal insufficiency and the development of postoperative pleural or pericardial effusion (<i>p</i> < 0.001, <i>p</i> = 0.016). A significant decrease in BMI was observed in patients >75 years of age compared to the 60–74 years group (27.3 vs. 28.2 kg/m<sup>2</sup>, <i>p</i> = 0.007). The development of critical illnesses such as myopathy and neuropathy (CIP/CIM) was age-dependent and increased significantly with age (<i>p</i> = 0.04). Hospitalization duration and mortality also increased significantly with age (<i>p</i> = 0.013, <i>p</i> < 0.001). Conclusions: It appears that elderly patients with advanced renal failure have a significantly higher risk of mortality, postoperative renal failure, need for dialysis, and possibly the development of pleural and pericardial effusions in mitral valve surgery. In addition, more frequent CIP/CIM with concomitant decrease in BMI in the most advanced age group indicate sarcopenia and thus an additional feature of frailty besides renal failure. |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T17:43:43Z |
| publishDate | 2022-11-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-8fd5fe37d2254d84bb22b16dc9ae3e4c2023-11-24T11:19:43ZengMDPI AGJournal of Clinical Medicine2077-03832022-11-011123690710.3390/jcm11236907What Exactly Makes Age a Risk Factor for an Unfavorable Outcome after Mitral Valve Surgery?Roya Ostovar0Filip Schröter1Ralf-Uwe Kühnel2Martin Hartrumpf3Johannes Maximilian Albes4Department of Cardiovascular Surgery, Heart Center Brandenburg, University Hospital Brandenburg Medical School, “Theodor Fontane”, Faculty of Health Sciences Brandenburg, 16321 Bernau, GermanyDepartment of Cardiovascular Surgery, Heart Center Brandenburg, University Hospital Brandenburg Medical School, “Theodor Fontane”, Faculty of Health Sciences Brandenburg, 16321 Bernau, GermanyDepartment of Cardiovascular Surgery, Heart Center Brandenburg, University Hospital Brandenburg Medical School, “Theodor Fontane”, Faculty of Health Sciences Brandenburg, 16321 Bernau, GermanyDepartment of Cardiovascular Surgery, Heart Center Brandenburg, University Hospital Brandenburg Medical School, “Theodor Fontane”, Faculty of Health Sciences Brandenburg, 16321 Bernau, GermanyDepartment of Cardiovascular Surgery, Heart Center Brandenburg, University Hospital Brandenburg Medical School, “Theodor Fontane”, Faculty of Health Sciences Brandenburg, 16321 Bernau, GermanyObjective: Age has an undeniable impact on perioperative mortality. However, it is not necessarily a predictor of frailty per se, as older patients have different outcomes. To verify specific conditions underlying frailty, we examined demographics, comorbidities, frequency, and distribution of postoperative complications influencing outcomes in a challenging cohort of patients undergoing mitral valve surgery. Methods: The study enrolled 1627 patients who underwent mitral valve surgery. Patients younger than 40 years who had been diagnosed with endocarditis were excluded. Patients were divided into three groups with ages ranging from 40–59 (<i>n</i> = 319), 60–74 (<i>n</i> = 795), and >75 years (<i>n</i> = 513). Baseline, comorbidities, postoperative complications, and mortality were recorded. Results: The older the patients were, the more frequently they suffered from pre- and postoperative renal insufficiency (<i>p</i> < 0.001). The likelihood of postoperative renal failure requiring dialysis was significantly higher with pre-existing renal failure. There was a significant association between postoperative renal insufficiency and the development of postoperative pleural or pericardial effusion (<i>p</i> < 0.001, <i>p</i> = 0.016). A significant decrease in BMI was observed in patients >75 years of age compared to the 60–74 years group (27.3 vs. 28.2 kg/m<sup>2</sup>, <i>p</i> = 0.007). The development of critical illnesses such as myopathy and neuropathy (CIP/CIM) was age-dependent and increased significantly with age (<i>p</i> = 0.04). Hospitalization duration and mortality also increased significantly with age (<i>p</i> = 0.013, <i>p</i> < 0.001). Conclusions: It appears that elderly patients with advanced renal failure have a significantly higher risk of mortality, postoperative renal failure, need for dialysis, and possibly the development of pleural and pericardial effusions in mitral valve surgery. In addition, more frequent CIP/CIM with concomitant decrease in BMI in the most advanced age group indicate sarcopenia and thus an additional feature of frailty besides renal failure.https://www.mdpi.com/2077-0383/11/23/6907outcomeagingmitral valve surgeryfrailtykidney disease |
| spellingShingle | Roya Ostovar Filip Schröter Ralf-Uwe Kühnel Martin Hartrumpf Johannes Maximilian Albes What Exactly Makes Age a Risk Factor for an Unfavorable Outcome after Mitral Valve Surgery? Journal of Clinical Medicine outcome aging mitral valve surgery frailty kidney disease |
| title | What Exactly Makes Age a Risk Factor for an Unfavorable Outcome after Mitral Valve Surgery? |
| title_full | What Exactly Makes Age a Risk Factor for an Unfavorable Outcome after Mitral Valve Surgery? |
| title_fullStr | What Exactly Makes Age a Risk Factor for an Unfavorable Outcome after Mitral Valve Surgery? |
| title_full_unstemmed | What Exactly Makes Age a Risk Factor for an Unfavorable Outcome after Mitral Valve Surgery? |
| title_short | What Exactly Makes Age a Risk Factor for an Unfavorable Outcome after Mitral Valve Surgery? |
| title_sort | what exactly makes age a risk factor for an unfavorable outcome after mitral valve surgery |
| topic | outcome aging mitral valve surgery frailty kidney disease |
| url | https://www.mdpi.com/2077-0383/11/23/6907 |
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