The clinical and billing records of 250 patients (173 men and 77 women) undergoing isolated coronary artery bypass grafting between 1987 and mid-1990 were retrospectively reviewed to determine charges and clinical results as related to age. Patients were stratified by age into five groups of 50 consecutive patients each: group 1, less than 50 years of age; group 2, 50 to 59 years; group 3, 60 to 69 years; group 4, 70 to 79 years; and group 5, 80 years or older. The groups were compared in regard to perioperative clinical variables, long-term follow-up, and total charges. Group 5 had significantly more postoperative complications than the other four groups (p < 0.05). In addition, length of postoperative hospitalization was significantly longer in group 5 compared with groups 1, 2, and 3 (p < 0.05), and operative mortality in group 5 (20%) was significantly higher than that in the other four groups. The mean total charges for group 5 were $73,399, which was significantly higher than the totals in the other four groups (p < 0.05). Actuarial 3-year survival for the hospital survivors was 87%, 89%, 78%, 82%, and 60% for groups 1, 2, 3, 4, and 5, respectively (p < 0.001). Postoperative performance as measured by the Karnofsky scale was significantly lower in group 5 than in groups 1 and 2 (p < 0.05). These data support the premise that elderly patients undergoing coronary artery bypass grafting have more complications, longer hospitalizations, and higher operative mortality than younger patients.(ABSTRACT TRUNCATED AT 250 WORDS)