| Effect of gender on postoperative outcomes and hospital stays after coronary artery bypass grafting. | |
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MedLine Citation:
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PMID: 10320257 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Compared to men, women undergoing coronary artery bypass grafting appear to have a higher morbidity and mortality, particularly in the perioperative period. This study was designed to answer the questions of whether such differences in clinical outcomes between men and women still exist with improvements in surgical techniques and determine whether it is gender or associated comorbid conditions in women that lead to higher morbidity. METHODS: An analysis of a single center's contemporary experience (1994 to 1997) of 1,743 consecutive patients undergoing primary coronary artery bypass grafting was performed. Only reoperations were excluded. Data were collected prospectively and presented as mean +/- standard deviation (p<0.05). RESULTS: Women represented 30.0% of patients. Compared with men, women were older (68.4 versus 63.8 years; p<0.05), and had more urgent surgical interventions (70.0% versus 56.7%; p<0.05), a higher incidence of diabetes (42.1% versus 26.7%; p<0.05), hypertension (82.0% versus 73.9%; p<0.05), lower body surface area (1.73+/-0.18 m2 versus 2.03+/-0.19 m2; p<0.05), and hematocrit (31.7%+/-3.9% versus 36.2%+/-3.9%; p<0.05). Ejection fraction, incidence of previous myocardial infarction, chronic obstructive pulmonary disease, left main (LM) disease, renal insufficiency, extent of coronary disease, and preoperative intraaortic balloon pump were similar. Women received fewer arterial grafts (91.0% versus 95.5%; p<0.05) and distal anastomoses (3.31+/-0.88 versus 3.49+/-0.94 p<0.05). Despite these differences, there were no statistical differences in the incidence of postoperative death (1.5% versus 1.0%), myocardial infarction (0.6% versus 0.6%), or cerebrovascular accident/transient ischemic attack (1.1% versus 0.4%) between men and women. Women had a higher inotropic support (10.2% versus 4.4%; p<0.05) and longer hospital stays (7.3+/-5.7 days versus 6.3+/-4.2 days; p<0.05). Using multivariate analysis, female gender was not an independent predictor of death or postoperative complications but was a predictor of length of hospital stay, use of arterial grafts, and extent of coronary revascularization. CONCLUSIONS: After accounting for differences in their risk variables, the incidences of death, perioperative myocardial infarction and cerebrovascular accident/ transient ischemic attack after coronary artery bypass grafting in women and men were not statistically significant. Perioperative complications are related to comorbid risk factors but not to female gender itself. Further studies are warranted. |
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Authors:
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G S Aldea; J M Gaudiani; O M Shapira; A K Jacobs; J Weinberg; A L Cupples; H L Lazar; R J Shemin |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 67 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 1999 Apr |
Date Detail:
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Created Date: 1999-05-25 Completed Date: 1999-05-25 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1097-103 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiothoracic Surgery, Boston University School of Medicine, Boston Medical Center, Massachusetts, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Aged Body Surface Area Cardiotonic Agents / therapeutic use Coronary Artery Bypass* / mortality Diabetes Complications Female Hematocrit Humans Hypertension / complications Length of Stay* Male Middle Aged Postoperative Complications Prospective Studies Risk Factors Sex Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Cardiotonic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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