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Biological age and its role in stratification of cardiac risk

https://doi.org/10.24884/0042-4625-2019-178-1-17-20

Abstract

Risk stratification in elderly patients is very important, as none of the applied models for the prediction of mortality in cardiac surgery does not take into account the whole complex of physiological features of the aging organism.

The objective was to analyze the effectiveness of the method of qualitative assessment of biological age.

Material and methods. Our study included 127 patients (87 male and 40 female) aged 65 to 84 years (mean age – 72.2±4.7 years) who underwent elective cardiac surgery. Perioperative factors were analyzed. The primary endpoint of the study was a 30-day mortality rate.

Results. The total 30-day mortality rate was 13.4 % (17 patients). Perioperative predictors of 30-day mortality rate were the calculated values of the CAF scale (p=0.006), the surgery volume (p=0.044), the use of extracorporeal blood circulation (p=0.048).

Conclusion. The use of qualitative assessment of biological age allows to more accurate predict the mortality in cardiac elderly patients.

About the Authors

N. N. Shikhverdiev
Military Medical Academy named after S. M. Kirov
Russian Federation

Nazim N. Shikhverdiev 

St. Petersburg



D. I. Ushakov
Military Medical Academy named after S. M. Kirov
Russian Federation

Corresponding author: Dmitrii I. Ushakov, Military Medical Academy named after S. M. Kirov, 6 Academica Lebedeva street, St. Petersburg, Russia, 194044. E-mail: ushakovdmitrii87@gmail.com.


Competing Interests:

 

 



A. S. Peleshok
Military Medical Academy named after S. M. Kirov
Russian Federation

Andrei S. Peleshok

St. Petersburg



V. A. Krivopalov
Military Medical Academy named after S. M. Kirov
Russian Federation

Andrei S. Peleshok 

St. Petersburg



V. A. Sizenko
Military Medical Academy named after S. M. Kirov
Russian Federation

Valerii V. Sizenko 

St. Petersburg

 



References

1. Nashef S., Roques F., Michel P. et al. European System for Cardiac Operative Risk Evaluation (EuroSCORE) // Eur. J. Cardiothorac. Surg. 1999. Vol. 16. P. 9–13.

2. Nashef S., Roques F., Sharples L. et al. EuroSCORE II // Eur. J. Cardiothorac. Surg. 2012. Vol. 41. P. 734–745.

3. Qadir I., Alamzaib S., Ahmad M. et al. EuroSCORE versus EuroSCORE II versus Society of Thoracic Surgeons risk algorithm // Asian Cardiovasc. Thorac. Ann. 2014. Vol. 22. P. 165–171.

4. Nishimura R., Otto C. M., Bonow R. O. et al. AHA/ACC guideline for the management of patients with valvular heart disease : a report of the American College of Cardiology / Am. Heart Association Task Force on Practice Guidelines // J. Thorac. Cardiovasc. Surg. 2014. Vol. 148. P. 132.

5. Shihverdiev N. N., Ushakov D. I., Luk’yanov N.G . Ocenka biologicheskogo vozrasta v kardiokhirurgii. Grudnaya i serdechno-sosudistaya khirurgiya. 2017. № 1, pp. 20–27. (In Russ.).

6. Afilalo J., Mottillo S., Alexander K. P. et al. Identification of vulnerable elderly before cardiac surgery : a comparison of different survey scales // JACC. 2011. Vol. 57. P. 1395–1398.

7. Furukawa H., Tanemoto K. Frailty in cardiothoracic surgery : systematic review of the literature // Gen. Thorac. Cardiovasc. Surg. 2015. Vol. 63. P. 425–433.

8. Yusuf S., Leonidas V., Roberto P. et al. Systematic review on the predictive ability of frailty assessment measures in cardiac surgery // Interactive CardioVascular and Thoracic Surgery. 2017. Vol 24. P. 619–624.

9. Clegg A., Young J., Iliffe S. et al. Frailty in elderly people // Lancet. 2013. Vol. 381. P. 752–762.

10. Afilalo J., Mottillo S., Eisenberg M. J. et al. Addition of frailty and disability to cardiac surgery risk scores identifies elderly patients at high risk of mortality or major morbidity // Circ. Cardiovasc. Qual. Outcomes. 2012. Vol. 5. P. 222–228.

11. Sepehri A., Beggs T., Hassan A. et al. The impact of frailty on outcomes after cardiac surgery : A systematic review // J. Thorac. Cardiovasc. Surg. 2014. Vol. 148 (6). Р. 3110–3117.

12. Sündermann S. Dademasch A., Praetorius J. et al. Comprehensive assessment of frailty for elderly high-risk patients undergoing cardiac surgery // Eur. J. Cardiothorac. Surg. 2011.Vol. 39, № 1. Р. 33–37.

13. Wallis S. J., Wall J., Biram R. W. et al. Association of the clinical frailty scale with hospital outcomes // Q.J.M. 2015. Vol. 108. Р. 943–949.

14. Saleh H. Z., Shaw M., Fabri B. M. et al. Does avoidance of cardiopulmonary bypass confer any benefits in octogenarians undergoing coronary surgery? // Interactive Cardiovascular and Thoracic Surgery. 2011. Vol. 12 (3). P. 435–439.

15. LaPar D. J., Bhamidipati C. M., Reece T. B. et al. Is off-pump coronary artery bypass grafting superior to conventional bypass in octogenarians? // J. Thorac. Cardiovasc. Surg. 2011. Vol. 141 (1). P. 81–90.

16. Shihverdiev N. N., Peleshok A. S., Ushakov D. I. i dr. Vliyanie starcheskoj dryahlosti na iskhody lecheniya kardiohirurgicheskih pacientov. Vestnik Voenno-medicinskoj akademii. 2017. Vol. 3, № 59, pp. 18–21. (In Russ.).


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For citations:


Shikhverdiev N.N., Ushakov D.I., Peleshok A.S., Krivopalov V.A., Sizenko V.A. Biological age and its role in stratification of cardiac risk. Grekov's Bulletin of Surgery. 2019;178(1):17-20. (In Russ.) https://doi.org/10.24884/0042-4625-2019-178-1-17-20

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ISSN 0042-4625 (Print)
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