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Ann Thorac Surg 2001;71:507-511
© 2001 The Society of Thoracic Surgeons

Original article: cardiovascular

Improved in-hospital mortality in women undergoing coronary artery bypass grafting

Daniel J. O’Rourke, MDa, David J. Malenka, MDb, Elaine M. Olmstead, BAb, Hebe B. Quinton, MSb, John H. Sanders, Jr, MDb, Stephen J. Lahey, MDc, Mitchell Norotsky, MDd, Reed D. Quinn, MDe, Yvon R. Baribeau, MDf, Felix Hernandez, Jr, MDg, Mary P. Fillinger, MDb, Gerald T. O’Connor, PhDh, for the Northern New England Cardiovascular Disease Study Group

a Section of Cardiology, Veterans Affairs Hospital, White River Junction, Vermont, USA
b Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
c Beth Israel-Deaconess Medical Center, Boston, Massachusetts, USA
d Fletcher Allen Health Care, Burlington, Vermont, USA
e Maine Medical Center, Portland, Maine, USA
f Catholic Medical Center, Manchester, New Hampshire, USA
g Eastern Maine Medical Center, Bangor, Maine, USA
h Center For the Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, New Hampshire, USA

Accepted for publication June 13, 2000.

Address reprint requests to Dr O’Rourke, Medical Service-Cardiology, Veteran Affairs Medical Center, White River Junction, VT 05001
e-mail: Daniel.ORourke{at}Hitchcock.org

Background. Few studies have examined the changes in in-hospital mortality for women over time. We describe the changing case mix and mortality for women undergoing coronary artery bypass grafting (CABG) from 1987 to 1997 in northern New England.

Methods. Data were collected on 8,029 women and 21,139 men undergoing isolated CABG. The study consisted of three time periods (1987 to 1989, 1990 to 1992, and 1993 to 1997) to account for regional efforts to improve quality of care that occurred during 1990 to 1992.

Results. Compared with 1987 to 1989, women undergoing CABG in 1993 to 1997 were older, had poorer ventricular function, and more often required urgent or emergency operations. The crude and adjusted mortality rates for both women and men decreased significantly over time. The absolute magnitude of the change in adjusted rates was greater for women (3.1%) than for men (1.5%). Although women represented only 28% of the study population, the decrease in their mortality accounted for 44% of the total decrease in adjusted mortality during the study period.

Conclusions. Over the last decade there has been a marked decrease in CABG mortality for women, despite a worsening case mix.




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