Cardiac procedures

Our population, both nationally and worldwide, is getting increasingly older. The proportion of people aged 65 and older in the United States is projected to increase from 35 million (12.4%) to 71 million (19.6%) by 2030 and 82 million by 2050.¹ Global trends are similar: people aged 65 and older are expected to make up 12% of the population by 2030 and 20% of the population by 2050. Considering that older patients have invasive procedures at almost four times the frequency of people younger than 65, this will significantly affect our health care system.² Because there are a greater number of older patients, surgery for cardiovascular disease is increasing. Compounding this, patients are increasingly presenting at an older age and later in their disease processes. For instance, in 1983, 12% of coronary artery bypass graft (CABG) patients were older than 65 years of age. Just 10 years later, half the patients undergoing CABG were older than 65 years of age.³ Today, the average age of CABG surgery patients is 66 years of age.⁴ For cardiac surgery, the 30-day mortality is estimated to increase by a factor of 1.55 per decade of age, compared with noncardiac surgery at 1.35 per decade of age.⁵