American heart journal plus : cardiology research and practice · 2023
Sex-specific disparities in patients undergoing isolated CABG.
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Dassanayake Maya T, Norton Elizabeth L, Ward Alison F, Wenger Nanette K
Аннотация
STUDY OBJECTIVE: Examine sex-specific characteristics in patients undergoing coronary artery bypass grafting (CABG) at our institution.
DESIGN: Retrospective chart review was performed utilizing our institutional Society of Thoracic Surgeons (STS) database.
SETTING: An academic, quaternary care center from 2010 to 2021.
PARTICIPANTS: 3163 females and 9573 males underwent isolated CABG.
INTERVENTIONS: The institutional STS database was queried for preoperative, intraoperative, and postoperative variables.
MAIN OUTCOME MEASURES: Univariate comparisons between female and male groups were performed using chi-squared tests or fisher exact tests. Multivariate logistic regression was used to assess risk factors for 30-day mortality.
RESULTS: Females had more preoperative comorbidities than males, including hypertension, diabetes, peripheral arterial disease, cerebrovascular disease, renal failure, and prior myocardial infarction. Females more frequently underwent urgent (61 % vs. 58 %) or emergent CABG (5.8 % vs. 4.3 %) compared to males (p < 0.0001). Females experienced longer total intensive care unit (ICU) hours (48.3 h vs. 43.5 h) (p < 0.0001), were more frequently discharged to an extended care facility (13 % vs. 6.4 %) (p < 0.0001) and prescribed less aspirin and beta blocker therapy at discharge than males. In-hospital mortality was higher in females (1.9 % vs. 1.2 %, p = 0.002), as was 30-day mortality (2.7 % vs. 1.6 %, p = 0.0001). Female sex was an independent risk factor for 30-day mortality (odds ratio = 1.46, 95 % CI: 1.06, 2.03, p = 0.02).
CONCLUSION: Over the past decade, females undergoing CABG had more preoperative comorbidities, urgent and emergent operations, longer postoperative ICU stay and a higher risk of mortality than their male counterparts. Further studies must investigate these disparities to improve outcomes for females undergoing CABG.
DESIGN: Retrospective chart review was performed utilizing our institutional Society of Thoracic Surgeons (STS) database.
SETTING: An academic, quaternary care center from 2010 to 2021.
PARTICIPANTS: 3163 females and 9573 males underwent isolated CABG.
INTERVENTIONS: The institutional STS database was queried for preoperative, intraoperative, and postoperative variables.
MAIN OUTCOME MEASURES: Univariate comparisons between female and male groups were performed using chi-squared tests or fisher exact tests. Multivariate logistic regression was used to assess risk factors for 30-day mortality.
RESULTS: Females had more preoperative comorbidities than males, including hypertension, diabetes, peripheral arterial disease, cerebrovascular disease, renal failure, and prior myocardial infarction. Females more frequently underwent urgent (61 % vs. 58 %) or emergent CABG (5.8 % vs. 4.3 %) compared to males (p < 0.0001). Females experienced longer total intensive care unit (ICU) hours (48.3 h vs. 43.5 h) (p < 0.0001), were more frequently discharged to an extended care facility (13 % vs. 6.4 %) (p < 0.0001) and prescribed less aspirin and beta blocker therapy at discharge than males. In-hospital mortality was higher in females (1.9 % vs. 1.2 %, p = 0.002), as was 30-day mortality (2.7 % vs. 1.6 %, p = 0.0001). Female sex was an independent risk factor for 30-day mortality (odds ratio = 1.46, 95 % CI: 1.06, 2.03, p = 0.02).
CONCLUSION: Over the past decade, females undergoing CABG had more preoperative comorbidities, urgent and emergent operations, longer postoperative ICU stay and a higher risk of mortality than their male counterparts. Further studies must investigate these disparities to improve outcomes for females undergoing CABG.