IJCS | Volume 31, Nº3, May/ June 2018

262 Kaufman et al. Mortality in Elderly Individuals Submitted to Coronary Artery Bypass Grafting International Journal of Cardiovascular Sciences. 2018;31(3)258-263 Original Article elective surgery or those with fewer comorbidities, the risk is similar to that of younger patients. 18,19 The mortality among older patients was much higher than that assessed in the general population, according to a previous study performed by our group. The assessment of all patients showed an index of 10.3%, compared to 22.3% in the current cohort. However, when we compare it with some cohorts of patients over 70 years of age, one observes very similar mortality rates. 10,20 Regarding the predictors of mortality, it is known that emergency surgery in the elderly has a negative impact on prognosis in the postoperative evolution of patients, with a risk of death up to 55-fold higher in some series. 21 The presence of peripheral atherosclerotic disease is closely related to age and the highest number of risk factors for coronary disease. Associated with this, there have been reports that graft quality is worse in these patients. The PREVENT IV study demonstrated that patients with peripheral vascular disease have a 3.3-fold increased risk of death, infarction or new revascularization in 5 years, but without an impact in the first 30 days after surgery. This fact is supported by two other studies that demonstrated that the impact of peripheral vascular disease lies in the long term. However, none of these studies have studied only the elderly population, a fact that may explain why the combination of advanced age with peripheral vascular disease shows a worse prognosis than isolated peripheral vascular disease in the postoperative period of coronary artery bypass grafting. 22-24 When making comparisons with other populations, one needs to keep in mind some peculiarities of the assessed patients. Our patients were from the Brazilian Unified Heath System (SUS), which, for the most part, have a more unfavorable socioeconomic condition than those from the private health care network and from other countries, in addition to having less access to specialized care. 25 Conclusion The predictors of surgical death in the septuagenarians of this assessed sample were the need for emergency surgery, combined valvular procedure and the presence of peripheral vascular disease. Author contributions Conception and design of the research: Azevedo VMP, Xavier RMA, Chaves RBM. Acquisition of data: Azevedo VMP, Xavier RMA, Chaves RBM. Analysis and interpretation of the data: Kaufman R, Azevedo VMP, Sá RMG, Geller M, Xavier RMA, Chaves RBM, Castier MB. Statistical analysis: Kaufman R, Azevedo VMP, Geller M. Writing of the manuscript: Kaufman R, Azevedo VMP, Sá RMG, Xavier RMA, Chaves RBM, Castier MB. Critical revision of themanuscript for intellectual content: Kaufman R, Azevedo VMP, Castier MB. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This article is part of the thesis of Doctoral submitted by Renato Kaufman, from Universidade do Estado do Rio de Janeiro . Ethics approval and consent to participate This study was approved by the Ethics Committee of the Instituto Nacional de Cardiologia under the protocol number 0117/110906. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study. 1. Brasil. Ministério da Saúde. Datasus. [Internet]. Banco de dados do Sistema Único de Saúde. [Acesso em2015 jun 18]. Disponível em: http:// www.datasus.org.br 2. Grundy EMD. The epidemiology of aging. In: Tallis RC, Fillit HW. (editors). Brocklehurst’s textbook of geriatric medicine and gerontology. Philadelphia: Elsevier Science Ltd; 2003. p. 3-20. 3. Schramm JM, Oliveira AF, Leite IC, Valente JG, Gadelha AM, Portela MC, et al. Epidemiological transition and the study of burden of disease in Brazil. Ciênc Saúde Coletiva 2004;9(4):897-908. doi: http://dx.doi. org/10.1590/S1413-81232004000400011. 4. Fechine BR, Trompieri NO. Processo de envelhecimento: as principais alterações que acontecem com o idoso com o passar dos anos. Rev References