Impact of gender on outcome following coronary artery bypass graft ing surgery

Background. Women experience greater complications and early mortality aft er both percutaneous interventions and coronary bypass surgery (CABG). Coronary artery disease is becoming more prevalent among women. Th e aim of the study was to determine whether gender diff erences in outcomes of surgical treatment persist at our institution. Methods. A retrospective review of 3177 consecutive CABG patients operated on at our institution during a fi ve-year period. A number of demographic and preoperative risk factors were analyzed to evaluate the risk of surgical procedure. Intraoperative variables refl ected the surgical and anesthetic management of the patients. Mortality was the primary outcome, but major morbidity was also analyzed. Logistic regression analysis was performed to identify the independent predictors of postoperative mortality. Results. Th e observed crude mortality rate was higher in women than in men (5.2% vs 2.8%, p < 0.05). Women were older (67.5 ± 8.3 vs 63.1 ± 9.4 years, p < 0.001) and had a greater incidence of comorbidities. Th e internal thoracic artery as a conduit was used with a lower rate in female patients (62.5% vs 77.8%, p < 0.01). Women had a higher rate of low cardiac output syndrome, were less likely to be extubated early following the procedure and required a higher rate of blood transfusions (45.2% vs 25.4%, p < 0.01). Logistic regression analysis revealed that age, left ventricle ejection fraction and female gender were signifi cant independent predictors of postoperative mortality. Conclusion. Despite advances in surgical and anesthetic techniques, female patients are operated on with an almost twice as high mortality rate as men. Th e risk profi le of female patients diff ers greatly from male patients. Th ese factors could have a negative impact on the results of surgical treatment of women.