80'li Yaşlarda Açık Kalp Cerrahisi Sonrası Yaşam Kalitesinin “Karnofsky Skoru” ile Analizi

Amaç: Günümüzde ileri yaşta açık kalp cerrahisi gereken hastaların sayısı giderek artmaktadır. Birçok bildiri kalp cerrahisinin yaşlılarda güvenli ve kısa dönem sonuçlarının yararlı olduğunu göstermektedir. Bu retrospektif çalışmada; kliniğimizde açık kalp ameliyatı yapılan 80 yaş ve üzeri hastaların erken ve geç dönem sonuçları incelenmiş ve hastaların ameliyat sonrası yaşam kaliteleri; bir performans ve yaşam kalitesi değerlendirme yöntemi olan Karnofsky skorlama yöntemi kullanılarak analiz edildi. Yöntem: Kliniğimizde Eylül 2005 ile Şubat 2008 yılları arasında açık kalp ameliyatı yapılan 424 hastadan 32'sinin 80 yaş ve üzerinde ortalama 86,78±2.6 olduğu belirlendi. Elde edilen kayıtlar retrospektif olarak değerlendirildi. Bulgular: Hastalarımızın 19'u erkek , 13'ü ise kadındı. Hastalarımızdan 3'üne izole aortik valv replasmanı, 1 hastaya kombine koroner bypass + aortikkapakreplasmanı, 28hastayaiseizolekoronerbypasoperasyonuyapıldı. Sonuç: 80 yaş ve üzerindeki hasta grubunda açık kalp cerrahisi hastanede kalış süresinin uzaması ve normalden biraz daha yüksek ancak kabul edilebilir bir mortalite ve morbidite oranları göz önüne alınarak uygulanabilir. Bu hastaların erken safhada ameliyata yönlendirilmesi ve kardiyopulmoner bypass KPB tekniğinde yapılan hastaya özgü modifikasyonlar sonuçların iyileşmesinde etkili olmaktadır.

Anahtar Kelimeler:

açık kalp cerrahisi, yaşlılık, dokuzuncu dekat, sağ kalım, mortalite, yaşam kalitesi

The Analysis of Quality of Life With Karnofsky Scoring System in Octogenerians After Open Heart Surgery

Objective: Number of elderly patients who underwent open heart surgery increasesdaybyday. Also therearemany articles mentioning aboutthesafety and effi ciency of open heart surgery in elderly patients. That retrospective study aims to execute the quality of life by using “Karnofsky Performance Status Scale” for octogenarian patients underwent open heart surgery. We analyzed theperformancestatusof 32 patients todeterminetheirKarnofsky scorewhichcanshowtheirexactperformancestatuswithalgebraicresults. Methods: There were 32 octogenarian patients mean age 86,78 ±2.6 of totally424patients whounderwentopen heartsurgerybetweenthedatesof September 2005 and February 2008. Hospital records were analyzed retrospectively and compared with the current results. Results: There were 19 male and 13 female patients. Three of our patients underwentaortic valvereplacementoperation, onepatientwasunderwent coronary artery bypass grafting surgery combined with aortic valve replacement and 28 of all patients were underwent isolated coronary artery bypass grafting surgery. Conclusions: For octogenarian patients open heart surgery requires a little longer staysin hospital comparingwithyoungergroups. Butopen heart surgery can be performed with acceptable morbidity and mortality rates. For these patients early evaluation and admission to surgery improves the outcomes whereasimportantmodifi cations of cardiopulmonary bypass techniques are also eff ective.

Keywords:

open heart surgery, elderly patients, octogenarians, survival rates, mortality, quality of life,

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