The nineties have been characterized by a reappraisal of allocating expenditure for health care interventions. Coronary artery bypass in the elderly has emerged as an example of burgeoning expensive surgery whose appropriateness is under challenge. This book comprises the proceedings of an international symposium where world renowned leaders in aspects such as health economics, ethics, clinical cardiology, cardiac surgery, epidemiology, and health care policy discussed the need and outcome of the operation in old and very old patients. No other book has hitherto addressed this increasingly…mehr
The nineties have been characterized by a reappraisal of allocating expenditure for health care interventions. Coronary artery bypass in the elderly has emerged as an example of burgeoning expensive surgery whose appropriateness is under challenge. This book comprises the proceedings of an international symposium where world renowned leaders in aspects such as health economics, ethics, clinical cardiology, cardiac surgery, epidemiology, and health care policy discussed the need and outcome of the operation in old and very old patients. No other book has hitherto addressed this increasingly quoted intervention in debate on the right to health care for the elderly citizen. Clinical issues and operative results complement national costs and quantitated benefits in terms of quality of life as a justification for surgery. The book is addressed to cardiologists, geriatricians, cardiac surgeons, psychiatrists, rehabilitation physicians and public health care administrators.
Preface. Foreword; N.K. Wenger. Part One: Demographics and health policy. 1. Demographic and economic trends in Europe and the need for coronary bypass surgery; M. Schneider. 2. Do growing proportions of elderly mean more cardiovascular diseases? H. Hofmeister, L. Muecke. Part Two: Favourable clinical results of CABG in the elderly. 3. Isolated CABG in the elderly: operative results and risk factors over the past three decades; W.J. Keon. 4. Combined valve and coronary bypass surgery in the elderly; J. Szécsi, P. Herijgers, I. Scheys, W. Flameng. 5. Cardiac surgery in the octogenarians: perioperative results and clinical follow-up; F. Fontan, A. Becat, G. Fernandez, N. Sourdille, P. Reynaud, P. Montserrat. 6. Coronary artery bypass grafting and use of the LIMA in octogenarians; G. Sahar, E. Raanani, I. Hertz, R. Brauner, B.A. Vidne. Part Three: Health care costs of elderly CABG patients. 7. Age-specific costs of heart surgery and follow-up treatment in Germany; D. Chruscz, W. König. Part Four: Clinical, economical and ethical controversies. 8. Opportunities to improve the cost-effectiveness of CABG surgery; W.B. Stason. 9. Who gets bypass surgery - should the doctor, patient or computer decide? J. Kellett. 10. The economics of treatment choice. Making choices in coronary bypass surgery in the elderly; A. Maynard. 11. The role of age and life expectancy in prioritising health care; J. Harris. 12. When does the cost of living exceed the return on our investment? The social and economic consequences of coronary bypass surgery in the elderly; R.W. Evans. Part Five: The heart of the matter: Health-related quality of life after CABG in the elderly. 13. Coronary artery bypass surgery and health-related quality of life: Data from the National Health and Nutrition Examination Survey; P. Erickson. 14. The selection of health-related quality of life measures for older adults with cardiovascular disease; S.A. Shumaker, R. Anderson. 15. Survival and health-related quality of life of elderly patients undergoing cardiac surgery; N. Caine, S. Tait, J. Wallwork. 16. Health-related quality of life after coronary revascularization in older patients; P.D. Cleary, E. Guadagnoli, J.Z. Ayanian. 17. Longitudinal health-related quality of life assessment in 5 years after coronary artery bypass surgery &endash; does benefit continue with advancing age? R. Mohan, P.J. Walter, E. van Hove. 18. Health-related quality of life 5 years after coronary bypass surgery at age 75 or above: a research approach to item selection; P.J. Walter, R. Mohan, C. Cornelissen. Part Six: Rehabilitation. 19. Rehabilitation following coronary artery bypass graft surgery at elderly age; N.K. Wenger. Discussions. Index.
Preface. Foreword; N.K. Wenger. Part One: Demographics and health policy. 1. Demographic and economic trends in Europe and the need for coronary bypass surgery; M. Schneider. 2. Do growing proportions of elderly mean more cardiovascular diseases? H. Hofmeister, L. Muecke. Part Two: Favourable clinical results of CABG in the elderly. 3. Isolated CABG in the elderly: operative results and risk factors over the past three decades; W.J. Keon. 4. Combined valve and coronary bypass surgery in the elderly; J. Szécsi, P. Herijgers, I. Scheys, W. Flameng. 5. Cardiac surgery in the octogenarians: perioperative results and clinical follow-up; F. Fontan, A. Becat, G. Fernandez, N. Sourdille, P. Reynaud, P. Montserrat. 6. Coronary artery bypass grafting and use of the LIMA in octogenarians; G. Sahar, E. Raanani, I. Hertz, R. Brauner, B.A. Vidne. Part Three: Health care costs of elderly CABG patients. 7. Age-specific costs of heart surgery and follow-up treatment in Germany; D. Chruscz, W. König. Part Four: Clinical, economical and ethical controversies. 8. Opportunities to improve the cost-effectiveness of CABG surgery; W.B. Stason. 9. Who gets bypass surgery - should the doctor, patient or computer decide? J. Kellett. 10. The economics of treatment choice. Making choices in coronary bypass surgery in the elderly; A. Maynard. 11. The role of age and life expectancy in prioritising health care; J. Harris. 12. When does the cost of living exceed the return on our investment? The social and economic consequences of coronary bypass surgery in the elderly; R.W. Evans. Part Five: The heart of the matter: Health-related quality of life after CABG in the elderly. 13. Coronary artery bypass surgery and health-related quality of life: Data from the National Health and Nutrition Examination Survey; P. Erickson. 14. The selection of health-related quality of life measures for older adults with cardiovascular disease; S.A. Shumaker, R. Anderson. 15. Survival and health-related quality of life of elderly patients undergoing cardiac surgery; N. Caine, S. Tait, J. Wallwork. 16. Health-related quality of life after coronary revascularization in older patients; P.D. Cleary, E. Guadagnoli, J.Z. Ayanian. 17. Longitudinal health-related quality of life assessment in 5 years after coronary artery bypass surgery &endash; does benefit continue with advancing age? R. Mohan, P.J. Walter, E. van Hove. 18. Health-related quality of life 5 years after coronary bypass surgery at age 75 or above: a research approach to item selection; P.J. Walter, R. Mohan, C. Cornelissen. Part Six: Rehabilitation. 19. Rehabilitation following coronary artery bypass graft surgery at elderly age; N.K. Wenger. Discussions. Index.
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