Coronary artery bypass grafting costs more in those over age 65

A study by Dr. Gary Naglie and colleagues compared the direct medical costs of Coronary Artery Bypass Grafting (CABG) in people over age 65 to those under age 65. Even after adjusting for severity of heart disease and comorbidity, age remained a significant determinant of cost. The bulk of the cost difference was attributed to an increased length of hospital stay which increased intensive care unit and ward costs. Possible reasons cited for causing increased stays in the elderly included: older patients are more likely to develop postoperative atrial fibrillation, more neurological complications, late extubation and a decline in functional status and mobility associated with hospital admission itself that ultimately leads to longer stays. Having determined that CABG costs more in the elderly, the question still remains--is CABG in older people an efficient use of resources? Naglie et al. suggest that "further research should focus on strategies to reduce the incidence of complications in older patients undergoing CABG and on identifying modifiable factors that contribute to longer ICU and ward stays in this age group."

Source: Naglie G, Tansey C, Krahn M, O'Rourke K, Detsky AS, Bolley H. Direct costs of coronary artery bypass grafting in patients aged 65 years or more and those under age 65. CMAJ 1999;160(6):805-11.