Published Online
on November 3, 2003

A more recent version of this article appeared on November 25, 2003

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Submitted on May 21, 2003
Revised on August 25, 2003
Accepted on August 26, 2003

Sex Differences in Health Status After Coronary Artery Bypass Surgery

Viola Vaccarino MD, PhD^*, Zhen Qiu Lin PhD, Stanislav V. Kasl PhD, Jennifer A. Mattera MPH, Sarah A. Roumanis RN, Jerome L. Abramson PhD, and Harlan M. Krumholz MD

From the Department of Medicine, Division of Cardiology, Emory University School of Medicine (V.V., J.L.A.) and the Department of Epidemiology, Rollins School of Public Health, Emory University (V.V.), Atlanta, Ga; the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Conn (Z.Q.L., H.M.K., J.A.M., S.A.R.); and the Department of Epidemiology and Public Health (S.V.K.) and the Section of Cardiovascular Medicine, Department of Medicine (H.M.K.), Yale University School of Medicine, New Haven, Conn.

^* To whom correspondence should be addressed. E-mail: lvaccar{at}emory.edu.

Background--Although previous studies have shown functional improvements in patients who undergo coronary artery bypass graft (CABG) surgery, data are conflicting on whether the gains achieved by women are similar to or less than those achieved by men.

Methods and Results--We compared physical and psychological functional gains and readmission rates between 777 men and 295 women who underwent first CABG consecutively between February 1999 and February 2001. Physical function and mental health were measured by means of the Short Form 36-Item Health Survey (SF-36). At 6 months, both men and women showed, on average, a significant improvement in physical function and mental health, but men improved significantly more than women. After adjustment for baseline characteristics, the mean score improvement in women was half that of men for physical function (7.3 versus 14.0, P=0.0002) and 25% less than that of men for mental health (-3.0 versus 8.9, P=0.026). The absolute rates of adverse outcomes, such as hospital readmission, worsening functional status, and worsening mental health, were significantly higher in women (32.6%, 25.7%, and 17.5%, respectively) than in men (21.2%, 11.1%, and 12.6%, respectively) and remained significantly different in multivariable analysis.

Conclusions--CABG surgery is associated with lower functional gains and higher readmission rates in women compared with men 6 months after operation.

Key words: bypass • sex • prognosis

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