The Journal of thoracic and cardiovascular surgery · 2026
Patient-Surgeon Sex Concordance Affects Coronary Artery Bypass Grafting Outcomes.
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Ramdeen Sanjhai L, Wagner Catherine, Pegues J'undra N, Yang Jie, Hou Hechuan, Ibrahim Andrew M, Likosky Donald S, Thompson Mike P, Yang Bo, Hamilton Barbara C S, Romano Jennifer C, Ailawadi Gorav, Hawkins Robert B
Аннотация
OBJECTIVES: Evidence suggests that female patients may have superior outcomes with female surgeons. This study evaluated whether coronary artery bypass grafting (CABG) outcomes vary based on patient and surgeon sex.
METHODS: Medicare beneficiaries undergoing CABG (7/2016-12/2018) were evaluated. Reoperative, concomitant valve or aortic surgery were excluded. Surgeon sex was obtained by National Provider Identifier. Primary outcomes were risk-adjusted 30- and 90-day mortality and mid-term survival stratified by patient and surgeon sex. Regressions were risk-adjusted for patient demographics and comorbidities and included an interaction term for surgeon and patient sex.
RESULTS: There were 131,130 CABG cases by 2,924 surgeons, of whom 7.8% (213) were female and performed 3.7% (4,871) of CABGs. Female surgeons operated on patients with more comorbidities than male surgeons. Risk-adjusted mortality for male and female surgeons was similar at 30-days and 90-days (3.5 vs 3.7 and 5.2 vs 4.9, p>0.05). When stratified by patient sex, there was no difference in adjusted mortality for male patients by surgeon sex (p>0.05). While female patients had lower 30-day mortality with male versus female surgeons (4.1% vs 5.4%, p=0.044), there was no mortality difference at 90-days (5.8% vs 6.1%, p=0.667). Survival curves for female patients crossed at 90-days, and on landmark analysis female patients had better mid-term survival with female surgeons (HR 0.787 [0.623-0.981], p=0.042).
CONCLUSIONS: Female surgeons performed CABG on patients with higher comorbidity burden than male surgeons. While female patients had lower 30-day mortality with male surgeons, survival curves crossed at 90-days, after which survival was superior with female surgeons.
METHODS: Medicare beneficiaries undergoing CABG (7/2016-12/2018) were evaluated. Reoperative, concomitant valve or aortic surgery were excluded. Surgeon sex was obtained by National Provider Identifier. Primary outcomes were risk-adjusted 30- and 90-day mortality and mid-term survival stratified by patient and surgeon sex. Regressions were risk-adjusted for patient demographics and comorbidities and included an interaction term for surgeon and patient sex.
RESULTS: There were 131,130 CABG cases by 2,924 surgeons, of whom 7.8% (213) were female and performed 3.7% (4,871) of CABGs. Female surgeons operated on patients with more comorbidities than male surgeons. Risk-adjusted mortality for male and female surgeons was similar at 30-days and 90-days (3.5 vs 3.7 and 5.2 vs 4.9, p>0.05). When stratified by patient sex, there was no difference in adjusted mortality for male patients by surgeon sex (p>0.05). While female patients had lower 30-day mortality with male versus female surgeons (4.1% vs 5.4%, p=0.044), there was no mortality difference at 90-days (5.8% vs 6.1%, p=0.667). Survival curves for female patients crossed at 90-days, and on landmark analysis female patients had better mid-term survival with female surgeons (HR 0.787 [0.623-0.981], p=0.042).
CONCLUSIONS: Female surgeons performed CABG on patients with higher comorbidity burden than male surgeons. While female patients had lower 30-day mortality with male surgeons, survival curves crossed at 90-days, after which survival was superior with female surgeons.