%0 Journal Article %A S C Stoica %A F Cafferty %A J Kitcat %A R J F Baskett %A M Goddard %A L D Sharples %A F C Wells %A S A M Nashef %T Octogenarians undergoing cardiac surgery outlive their peers: a case for early referral %D 2006 %R 10.1136/hrt.2005.064451 %J Heart %P 503-506 %V 92 %N 4 %X Objective: To examine short and long term outcomes of octogenarians having heart operations and to analyse the interaction between patient and treatment factors. Methods: Multivariate analysis of prospectively collected data and a survival comparison with an age and sex matched national population. The outcomes were base in-hospital mortality, risk stratified by logistic EuroSCORE (European system for cardiac operative risk evaluation), and long term survival. Results: 12 461 consecutive patients (706 over 80 years) operated on between 1996 and 2003 in a regional UK unit were studied. Octogenarians more often had impaired ventricular function, pulmonary hypertension, and valve operations. They also included a higher proportion of women, had a higher serum creatinine concentration, and had a trend towards more unstable angina. Younger patients had a higher prevalence of previous cardiac operation, previous myocardial infarction, and diabetes. The in-hospital mortality rate was 3.9% for all patients (EuroSCORE predicted 6.1%, p < 0.001) and 9.8% for octogenarians (predicted 14.1%, p  =  0.002). Long bypass time and non-elective surgery increased the risk of death above EuroSCORE prediction in both groups. A greater proportion of octogenarians stayed in intensive care more than 24 hours (37% v 23%, p < 0.001). Long term survival was significantly better in the study patients than in a general population with the same age–sex distribution (survival rate at five years 82.1% v 55.9%, p < 0.001). Conclusions: Cardiac surgery in a UK population of octogenarians produced excellent results. Elective referrals should be encouraged in all age groups. %U https://heart.bmj.com/content/heartjnl/92/4/503.full.pdf