When death from heart disease, there are large differences between the länder. The German heart report. Die in Saxony-Anhalt clearly suffering more people to the heart than, for example, in Hamburg, Germany.
Should Grandma get with 91 a new heart valve? Doctors in Germany have answered such questions in the past few years, more and more often with Yes. The number of cardiac operations in elderly patients over 80 has increased since the year 2000, the German heart report 2018, which was presented on Thursday in Berlin. So much so, that this growth can be alone with the aging population does not explain.
The Numbers are documented in the new report. It was in the year 2000 in Germany, around 4225 cardiac surgery in the elderly, this Generation of 80 Plus, the most recent figure for 2017 already 16.242.
Critics now ask whether hospitals earn money with operations, the old people might not need. Dietrich Andresen, Chairman of the German heart Foundation, can understand such questions. It was something that, in Germany, beyond 80 for example, more pacemakers and Stents would be used than in other European countries. "It’s not too much operiert" but;, stresses Andresen.
Previously, there was no cardiac surgery in 70-Year-old
A significant effect on the growing operation in the age of the anesthetic, have to pay heart doctors explained Andresen. You can today run significantly gentler than 20 years ago. An 80-Year-old is at risk, therefore, less risk due to the ventilation later, lung or kidney damage. To this end, new surgical methods were. "That is to say, the chest must not be opened."
Wolfgang Harringer, President of the German society for thoracic-, cardiac – and vascular surgery, can well remember the past. "As I the end of the 80s as a heart surgeon began, there was in patients over 70 no operations on the heart. It was mostly a lot of to riskant", he reported. Heart valve replacement or repair – it had previously been operations of three to four hours of open heart, anesthesia, and follow-up care in the ICU. Today, the takes around 60 minutes. The OP will run through the groin artery or vein. General anesthesia is only on desire.
With all these advantages, a shorter recovery phase of an Operation is connected, and an improvement in the quality of life, says Harringer. He admits, however, that there is as yet no clear long-term results.
Cardiovascular disease is the Top Ten of death leading causes
In addition, today’s Generation of Over-80-Year-old Harringer is a completely different than in the past. "The people are by the Bank, a fitter and aktiver", he sums it up. "Many of them have a reasonable life style, and self-sufficient." If old patient wanted an Operation really, you have often better candidates than some of the Younger, the smoke, as well as Diabetes and Obesity.
Cardiovascular disease is a problem child in Germany. Even if the mortality rate dropped slightly, the Top Ten causes of death statistics. With more than 338.000 deaths per year, they are diseases, from cancer. "However, despite all the talk about it, there are more large misconduct. From Smoking to Übergewicht", Hugo Katus, President of the German society for cardiology in the balance sheet.
Big difference between the States of
This is a big difference between the States. Die in Saxony-Anhalt, Bremen and Mecklenburg-Western Pomerania, a lot more people to heart disease than in Hamburg, Berlin and Baden-Württemberg. Why this is so is not entirely clear.
The latest Figures for 2016 vary from about 290 heart deaths per 100,000 inhabitants in Saxony-Anhalt up to 184 heart deaths per 100,000 population in Hamburg. Age as a factor was eliminated from the statistics as well as possible.
In the tables, there is not alone an East-West differences. The statisticians look at the admissions in hospitals after an acute heart attack, the Saar value in the year 2017 with 305 patients per 100,000 population to a peak. The lowest heart attack-the number of logged-in Saxony, with 197 patients per 100,000 inhabitants.
"The striking difference in the number of acute heart attacks in the States can not yet explain if the age removed as a factor, or rural regions with longer rescue evaluated due to different werden", Dietrich Andresen, Chairman of the Executive Board of the German heart Foundation said. "Because we have a lot more parameters in the view, for example, the education level of the population, the health information in rural regions, factors such as Obesity, Smoking rates and the number of pre-existing conditions such as Diabetes." In addition, work would need to be taken into account, unemployment rates and social Status, supplemented Katus.
According to these findings, prevention should be targeted in the future. Already today we know that The individual and close care, the greater the success. Otherwise, Smoking patients, even after SURGERY and rehab. It makes a lot of sense to inform people in socially weak districts and regions targeted. Bremen tried that already. More Knowledge would probably help more than a larger number of cardiologists, he says Katus.
In the high age must be weighed
The high age. Even those who live healthy, then you can get problems with the heart. And then? "With the operations of the heart does not decide on the surgeon alone. Because the family doctors and the cardiologists vorgeschaltet" first;, surgeon Harringer says. "It is always an individual consideration in the Team."
When there are limits. "If the non-members make enormous pressure, would probably no-one an elderly, bed-ridden dementia patient in a nursing home at the heart operieren", he supplemented. "And people over 80 with advanced cancer would not recommended." For seniors without serious pre-existing conditions, whether heart surgery is no longer as big of a risk. "Because there is more to quality of life." Even if no one could estimate how many lives would be won years.
Striking is, however, that the procedures in Germany are not centralised and smaller hospitals did. Since economic Considerations may play a role, says Harringer. "According to the currently available data, we can exclude nor corroborate that some of these OPs would be superfluous – rather, the hospital balance sheet, improve the quality of life of the patients."