| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1999;67:1097-1103
© 1999 The Society of Thoracic Surgeons
a Cardiothoracic Surgery, Cardiology, and Public Health, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, USA
Accepted for publication November 2, 1998.
Address reprints to Dr Aldea, Division of Cardiothoracic Surgery, University of Washington, Box 356310, 1959 NE Pacific St, Seattle, WA 98195
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.
This article has been cited by other articles:
|
|
 |
|
  S. Siminelakis, A. Kotsanti, M. Siafakas, G. Dimakopoulos, S. Sismanidis, M. Koutentakis, C. Paziouros, and G. Papadopoulos Is there any difference in carotid stenosis between male and female patients undergoing coronary artery bypass grafting? Interactive CardioVascular and Thoracic Surgery, November 1, 2009; 9(5): 823 - 826. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. D. Puskas, P. D. Kilgo, O. M. Lattouf, V. H. Thourani, W. A. Cooper, T. A. Vassiliades, E. P. Chen, J. D. Vega, and R. A. Guyton Off-Pump Coronary Bypass Provides Reduced Mortality and Morbidity and Equivalent 10-Year Survival Ann. Thorac. Surg., October 1, 2008; 86(4): 1139 - 1146. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. H Mandegar, M. Marzban, A. H Lebaschi, P. Ghaboussi, A. R. Alamooti, and A. Ardalan Gender Influence on Hospital Mortality after Coronary Artery Bypass Surgery Asian Cardiovasc Thorac Ann, June 1, 2008; 16(3): 231 - 235. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Parolari, L. Dainese, M. Naliato, G. Polvani, C. Loardi, M. Trezzi, M. Fusari, C. Beverini, E. Tremoli, P. Biglioli, et al. Do Women Currently Receive the Same Standard of Care in Coronary Artery Bypass Graft Procedures as Men? A Propensity Analysis Ann. Thorac. Surg., March 1, 2008; 85(3): 885 - 890. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Albert, N. Halevy, and E. M. Antman Preoperative Evaluation for Cardiac Surgery Card. Surg. Adult, January 1, 2008; 3(2008): 261 - 280. [Full Text]
|
|
|
|
|
|
J. D. Puskas, F. H. Edwards, P. A. Pappas, S. O'Brien, E. D. Peterson, P. Kilgo, and T. B. Ferguson Jr Off-Pump Techniques Benefit Men and Women and Narrow the Disparity in Mortality After Coronary Bypass Grafting Ann. Thorac. Surg., November 1, 2007; 84(5): 1447 - 1456. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. D. Puskas, P. D. Kilgo, M. Kutner, S. V. Pusca, O. Lattouf, and R. A. Guyton Off-Pump Techniques Disproportionately Benefit Women and Narrow the Gender Disparity in Outcomes After Coronary Artery Bypass Surgery Circulation, September 11, 2007; 116(11_suppl): I-192 - I-199. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. H. Humphries, M. Gao, A. Pu, S. Lichtenstein, and C. R. Thompson Significant Improvement in Short-Term Mortality in Women Undergoing Coronary Artery Bypass Surgery (1991 to 2004) J. Am. Coll. Cardiol., April 10, 2007; 49(14): 1552 - 1558. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Ad, S. D. Barnett, and A. M. Speir The performance of the EuroSCORE and the Society of Thoracic Surgeons mortality risk score: the gender factor Interactive CardioVascular and Thoracic Surgery, April 1, 2007; 6(2): 192 - 195. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Pilote, K. Dasgupta, V. Guru, K. H. Humphries, J. McGrath, C. Norris, D. Rabi, J. Tremblay, A. Alamian, T. Barnett, et al. A comprehensive view of sex-specific issues related to cardiovascular disease Can. Med. Assoc. J., March 13, 2007; 176(6): S1 - S44. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G W Mikhail Coronary revascularisation in women Heart, May 1, 2006; 92(suppl_3): iii19 - iii23. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. K. Toumpoulis, C. E. Anagnostopoulos, S. K. Balaram, C. K. Rokkas, D. G. Swistel, R. C. Ashton Jr, and J. J. DeRose Jr Assessment of independent predictors for long-term mortality between women and men after coronary artery bypass grafting: Are women different from men? J. Thorac. Cardiovasc. Surg., February 1, 2006; 131(2): 343 - 351. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. H. Habib, A. Zacharias, T. A. Schwann, C. J. Riordan, S. J. Durham, and A. Shah Effects of Obesity and Small Body Size on Operative and Long-Term Outcomes of Coronary Artery Bypass Surgery: A Propensity-Matched Analysis Ann. Thorac. Surg., June 1, 2005; 79(6): 1976 - 1986. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. H. Edwards, V. A. Ferraris, D. M. Shahian, E. Peterson, A. P. Furnary, C. K. Haan, and C. R. Bridges Gender-Specific Practice Guidelines for Coronary Artery Bypass Surgery: Perioperative Management Ann. Thorac. Surg., June 1, 2005; 79(6): 2189 - 2194. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Bucerius, J. F. Gummert, T. Walther, M. A. Borger, N. Doll, V. Falk, and F. W. Mohr Impact of Off-Pump Coronary Bypass Grafting on the Prevalence of Adverse Perioperative Outcome in Women Undergoing Coronary Artery Bypass Grafting Surgery Ann. Thorac. Surg., March 1, 2005; 79(3): 807 - 812. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. A. Fox and N. A. Nussmeier Does Gender Influence the Likelihood or Types of Complications Following Cardiac Surgery? Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2004; 8(4): 283 - 295. [Abstract] [PDF]
|
|
|
|
|
|
V. Guru, S. E. Fremes, and J. V. Tu Time-related mortality for women after coronary artery bypass graft surgery: A population-based study J. Thorac. Cardiovasc. Surg., April 1, 2004; 127(4): 1158 - 1165. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Johnston, J. R. Goss, J. A. Malmgren, and J. A. Spertus Health status and social risk correlates of extended length of stay following coronary artery bypass surgery Ann. Thorac. Surg., February 1, 2004; 77(2): 557 - 562. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Vaccarino and C. G. Koch Long-term benefits of coronary bypass surgery: Are the gains for women less than for men? J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 1707 - 1711. [Full Text] [PDF]
|
|
|
|
|
|
C. G. Koch, F. Khandwala, N. Nussmeier, and E. H. Blackstone Gender and outcomes after coronary artery bypass grafting: a propensity-matched comparison J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 2032 - 2043. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. G. Koch, F. Khandwala, N. Nussmeier, and E. H. Blackstone Gender profiling in coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 2044 - 2051. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. G. Koch, C. M. Mangano, N. Schwann, and V. Vaccarino Is it gender, methodology, or something else? J. Thorac. Cardiovasc. Surg., October 1, 2003; 126(4): 932 - 935. [Full Text] [PDF]
|
|
|
|
|
|
R. H. Habib, A. Zacharias, T. A. Schwann, C. J. Riordan, S. J. Durham, and A. Shah Adverse effects of low hematocrit during cardiopulmonary bypass in the adult: Should current practice be changed? J. Thorac. Cardiovasc. Surg., June 1, 2003; 125(6): 1438 - 1450. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Athanasiou, S. Al-Ruzzeh, R. D. Stanbridge, R. P. Casula, B. E. Glenville, and M. Amrani Is the female gender an independent predictor of adverse outcome after off-pump coronary artery bypass grafting? Ann. Thorac. Surg., April 1, 2003; 75(4): 1153 - 1160. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Albert and E. M. Antman Preoperative Evaluation for Cardiac Surgery Card. Surg. Adult, January 1, 2003; 2(2003): 235 - 248. [Full Text]
|
|
|
|
|
|
N. A. Nussmeier, M. R. Marino, and W. K. Vaughn Hormone replacement therapy is associated with improved survival in women undergoing coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., December 1, 2002; 124(6): 1225 - 1229. [Abstract] [Full Text]
|
|
|
|
|
|
P. A. Kurlansky, E. A. Traad, D. L. Galbut, S. Singer, M. Zucker, and G. Ebra Coronary bypass surgery in women: a long-term comparative study of quality of life after bilateral internal mammary artery grafting in men and women Ann. Thorac. Surg., November 1, 2002; 74(5): 1517 - 1525. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Steuer, P. Blomqvist, F. Granath, B. Rydh, A. Ekbom, U. de Faire, and E. Stahle Hospital readmission after coronary artery bypass grafting: are women doing worse? Ann. Thorac. Surg., May 1, 2002; 73(5): 1380 - 1386. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Sadeghi, S. Sadeghi, Z. A. Mood, and A. Karimi Determinants of operative mortality following primary coronary artery bypass surgery Eur. J. Cardiothorac. Surg., February 1, 2002; 21(2): 187 - 192. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Kurlansky, E. A. Traad, D. L. Galbut, M. Zucker, and G. Ebra Efficacy of single versus bilateral internal mammary artery grafting in women: a long-term study Ann. Thorac. Surg., June 1, 2001; 71(6): 1949 - 1958. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Schwann, R. H. Habib, A. Zacharias, G. L. Parenteau, C. J. Riordan, S. J. Durham, and M. Engoren Effects of body size on operative, intermediate, and long-term outcomes after coronary artery bypass operation Ann. Thorac. Surg., February 1, 2001; 71(2): 521 - 530. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Reinecke, T. Fetsch, N. Roeder, C. Schmid, A. Winter, M. Ribbing, E. Berendes, M. Block, H. H. Scheld, G. Breithardt, et al. Emergency coronary artery bypass grafting after failed coronary angioplasty: what has changed in a decade? Ann. Thorac. Surg., December 1, 2000; 70(6): 1997 - 2003. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Vaccarino, J. L. Abramson, E. Veledar, and W. S. Weintraub Sex Differences in Hospital Mortality After Coronary Artery Bypass Surgery: Evidence for a Higher Mortality in Younger Women Circulation, March 12, 2002; 105(10): 1176 - 1181. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
