Differences between men and women in hospital mortality associated with coronary artery bypass graft surgery. The Northern New England Cardiovascular Disease Study Group.

Abstract

Background. A prospective study of patients undergoing coronary artery bypass graft surgery (CABG) was conducted to examine differences in hospital mortality by sex. Outcome data on 3055 CABG patients undergoing operation between 1987 and 1989 were examined for differences in patient, disease, and treatment factors.Methods and Results. Odds ratios (OR), risk differences, and 95% confidence intervals (CI95%) were calculated. Mortality rates for women (7.1%) and men (3.3%) differed, the OR (women versus men) being

Lack of gender and racial differences in surgery and mortality in hospitalized medicare beneficiaries with bleeding peptic ulcer

“…In several studies that used administrative data, as well as medical record review, African-American patients were found to have lower utilization of diagnostic and therapeutic procedures. Whereas most analyses have been limited to cardiac catheterization, coronary angioplasty, and coronary bypass grafting, [1][2][3][4]6,7 others have reported less frequent surgical intervention for African-American patients with colorectal cancer, 12 breast cancer, 13,14 and bladder cancer, 15 as well as lower rates of outpatient preventive services. 16,17 Although the concept of race is somewhat tenuous and may be a surrogate for socioeconomic status, 18 two reports from the Veterans Administration have demonstrated lower rates of cardiovascular procedures in African Americans, 2,3 suggesting that social and clinical factors are also important.…”

“…21 A series of studies has also reported lower use of invasive procedures and higher mortality for women with cardiovascular disease. [4][5][6][7] For example, women were 30% to 70% less likely to undergo cardiac catheterization and coronary bypass surgery after myocardial infarction, 4 as well as half as likely to undergo peripheral vascular surgery. 5 Similarly, mortality rates in women following acute myocardial infarction 7 and coronary bypass grafting 6 have been reported to be, respectively, 54% and 120% higher than in men.…”

“…[4][5][6][7] For example, women were 30% to 70% less likely to undergo cardiac catheterization and coronary bypass surgery after myocardial infarction, 4 as well as half as likely to undergo peripheral vascular surgery. 5 Similarly, mortality rates in women following acute myocardial infarction 7 and coronary bypass grafting 6 have been reported to be, respectively, 54% and 120% higher than in men. The etiology of the gender differences is not clear, but may be due in part to anatomic factors (i.e., coronary artery diameter), 6 or differences in results of noninvasive testing, 22 as well as possible physician or patient biases.…”

“…The studies that have utilized administrative data have generally documented lower utilization of selected angiographic and surgical procedures in African-American patients [1][2][3][4] and female patients, 5,6 as well as poorer survival following diagnosis. 6,7 Moreover, in analyses that have been limited to patients with equal access to a health care system, racial differences in therapy have also been reported, 2,3,8 suggesting that factors other than access to care may be involved in treatment decisions.…”

Mechanisms Responsible for Serotonin Vascular Reactivity Sex Differences in the Internal Mammary Artery

“…Compared with men, women have poorer outcomes after coronary artery bypass grafting (CABG), including increased in‐hospital mortality and hospital readmissions 1, 2, 3, 4…”