Impact of gender on outcome following coronary artery bypass grafting surgery

Abstract

Background. Women experience greater complications and early mortality after both percutaneous interventions and coronary bypass surgery (CABG). Coronary artery disease is becoming more prevalent among women. The aim of the study was to determine whether gender differences 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 five-year period. A number of demographic and preoperative risk factors were analyzed to evaluate the risk of surgical procedure. Intraoperative variables reflected 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. The 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. The 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 significant 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. The risk profile of female patients differs greatly from male patients. These factors could have a negative impact on the results of surgical treatment of women.

Randomized Controlled Trial between Perineal and Anal Repairs of Rectocele in Obstructed Defecation

“…In the transanal approach [33], a Hill‐Ferguson retractor was inserted into the anal canal, and the anterior rectal wall was exposed. With a finger inserted in the vagina, the true borders of the rectocele were delineated.…”

Is the risk of isolated coronary artery bypass graft surgery in women aged above 75 years higher compared to men?

“…Samalavicius et al [16] found no significant differences in the incidence of stroke between male and female patients, although the rate was quite high for the women. In correlation with the literature, we found higher rates of cognitive function disorder and stroke in the females in our study, but these were not statistically significant (p= 0.242).…”