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Cardiac surgery in the elderly: What goals of care?

Alessandra Pratesi, Francesco Orso, Camilla Ghiara, Aldo Lo Forte, Anna Chiara Baroncini, Maria Laura Di Meo, Emanuele Carassi, Samuele Baldasseroni
  • Alessandra Pratesi
    University of Florence, Italy
  • Francesco Orso
    University of Florence, Italy
  • Camilla Ghiara
    University of Florence, Italy
  • Aldo Lo Forte
    University of Florence, Italy
  • Anna Chiara Baroncini
    University of Florence, Italy
  • Maria Laura Di Meo
    University of Florence, Italy
  • Emanuele Carassi
    University of Florence, Italy

Abstract

At present, the majority of cardiac surgery interventions have been performed in the elderly with successful short-term mortality and morbidity, however significant difficulties must to be underlined about our capacity to predict long-term outcomes such as disability, worsening quality of life and loss of functional capacity.
The reason probably resides on inability to capture preoperative frailty phenotype with current cardiac surgery risk scores and consequently we are unable to outline the postoperative trajectory of an important patients’ centered outcome such as disability free survival. In this perspective, more than one geriatric statements have stressed the systematic underuse of patient reported outcomes in cardiovascular trials even after taking account of their relevance to older feel and wishes. Thus, in the next future is mandatory for geriatric cardiology community closes this gap of evidences through planning of trials in which patients’ centered outcomes are considered as primary goals of therapies as well as cardiovascular ones.

Keywords

Cardiac surgery; elderly; outcomes; frailty; disability.

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Submitted: 2017-05-17 12:00:52
Published: 2017-07-18 14:29:53
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Copyright (c) 2017 Alessandra Pratesi, Francesco Orso, Camilla Ghiara, Aldo Lo Forte, Anna Chiara Baroncini, Maria Laura Di Meo, Emanuele Carassi, Samuele Baldasseroni

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