CABG-Procedures in Patients with Advanced Age: Early Extubation and Fast Track Management as an Option?

In cardiac surgery shorter hospital stays and decreased costs can be reached by early extubation and fast-track management protocols. The feasibility of such protocols in elderly patients is still discussed controversially. We analyzed 800 consecutive patients undergoing CABG. Total 496 patients (62 %) underwent early extubation, defined as extubation within 6 h postoperatively (group I). In the early extubated group elderly patients of at least 70 years (n = 210, mean age 78.1 years) were compared with younger patients (n = 286, 61.2 years). The mean length of stay (LOS) in hospital for all patients extubated within 6 h was 9.1 days vs. 13.3 days for patients who underwent later extubation. The hospital mortality rate was comparable between the older and the younger group of patients (2.6 vs. 2.3%). We found a shorter LOS in hospital among the younger patients (8.5 1.3 vs. 10.2 1.3 days), although the LOS on ICU was similar (old: 31 5 vs. 26 4 h). The immediate extubation (before ICU) could be correlated to the most uncomplicated postoperative courses among all early extubated patients.