Association of gender with morbidity and mortality after isolated coronary artery bypass grafting. A propensity score matched analysis

Mahboob Alam, Vei Vei Lee, McArthur A. Elayda, Saima A. Shahzad, Eric Y. Yang, Vijay Nambi, Hani Jneid, Wei Pan, Stephanie Coulter, James M. Wilson, Kodangudi B. Ramanathan, Christie M. Ballantyne, Salim S. Virani

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

Introduction: There is conflicting evidence about the impact of gender on outcomes after coronary artery bypass grafting (CABG). Methods: We performed a multivariate logistic regression and propensity score matched analyses in 13,115 patients (75% men) who underwent CABG between January 1, 1995 and December 31, 2009. The primary outcome was in-hospital mortality. Secondary outcomes included post-operative respiratory failure, stroke, myocardial infarction, sternal and leg wound infections, atrial fibrillation (AF), renal failure, need for postoperative intra-aortic balloon pump (IABP) support, and length of hospital stay. Results: A higher proportion of women (184; 5.6%) suffered in-hospital death compared to men (264; 2.7%), p < 0.0001. After propensity score matching (n = 3600 total, 1800 in each group), female gender was an independent predictor of mortality after isolated CABG (odds ratio [OR] = 1.84; 95% confidence interval [CI] 1.22-2.78). Women also experienced a higher incidence of postoperative complications including stroke (3.8% vs. 2.3%, OR 1.37; 95% CI 1.08-1.73) and leg wound infection (3.4% vs. 1.7%, OR 1.75; 95% CI 1.36-2.54) on multivariate regression analyses. However, these differences were not significant after propensity score matching. We also observed a lower risk of post-operative AF (21.2% vs. 22.1%, OR 0.78; 95% CI 0.70-0.86) in women that remained significant after propensity matching (O.R. 0.76; 95% C.I. 0.65-0.90). Length of hospital stay was longer in women compared with men (11.9 ± 9.0 vs. 10.4 ± 9.2 days, p < 0.0001). Conclusions: Female gender is an independent predictor of increased mortality and a lower incidence of post-operative AF after isolated CABG.

Original languageEnglish (US)
Pages (from-to)180-184
Number of pages5
JournalInternational Journal of Cardiology
Volume167
Issue number1
DOIs
StatePublished - Jul 15 2013

Keywords

  • Coronary artery bypass graft
  • Gender
  • Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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