Relative Survival After Adult Cardiac Surgery: Analysis of the Italian Nationwide Registry Data

Objective: The authors aimed to investigate life expectancy after adult cardiac surgery. Setting: Nationwide study including University and non-University hospitals. Participants: Consecutive adult patients who underwent heart valve and coronary artery surgery from a nationwide administrative registry. Interventions: Surgical procedures on the heart valves and coronary arteries. Methods: The authors estimated the 10-year relative survival of adult patients who underwent surgery for heart valve diseases and coronary artery disease taken from a nationwide administrative registry. Measurements and Results: Overall, data on 415,472 patients were available for this study. Among them, 394,445 (94.9%) survived 90 days after surgery, and their 10-year survival was 58.0% (95% CI 57.8-58.3); the expected survival was 70.1%, and the relative survival was 0.83 (95% CI 0.82-0.83). Patients who underwent surgical repair of the mitral valve and aortic valve had relative survival of 0.96 and 0.92, respectively. Isolated coronary artery bypass grafting had a relative survival of 0.88. Surgical replacement of the heart valves had a relative survival below 0.80. Poor results with relative survival <0.70 were observed after complex cardiac surgery. Relative survival was <0.60 in patients who underwent doubleor triple-valve surgery combined with coronary artery surgery. The authors observed markedly lower relative survival among women (0.77, 95% CI 0.77-0.78) compared with men (0.86, 95% CI 0.85-0.86) at 10 years. Such a difference was observed after almost all different procedures. Conclusions: The present findings provided a picture of the real expectation in terms of the late survival of patients after having undergone adult cardiac surgery. This information should be communicated to patients and their relatives before surgery, and it may be relevant in the decisionmaking process and in planning tertiary prevention. (c) 2023 Elsevier Inc. All rights reserved.

Automated summary

This study aimed to investigate life expectancy after adult cardiac surgery. It included adult patients who underwent heart valve and coronary artery surgery from a nationwide administrative registry. The results showed that the 10-year survival rate was 58.0%, with a relative survival rate of 0.83. Different surgical procedures had varying relative survival rates, with surgical replacement of heart valves having a relative survival rate below 0.80.