Abstract 16137: Are Females Still at Higher Risk During Coronary Artery Bypass Grafting?
Objectives: Females undergoing cardiac surgery are historically known to have worse outcomes than males. However, the impact of gender on contemporary outcomes has not been examined. We hypothesized that outcomes for females following coronary artery bypass grafting (CABG) have improved in recent times and are equivalent to males.
Methods: From 2003–2007, 257,728 patient discharge records were evaluated using the Nationwide Inpatient Sample (NIS) database for isolated CABG operations. Patients were stratified by female (n=72,308, age=67.4±10.9) versus male (n=185,420, age=64.7±10.7) gender and by year of operation. Univariate and multivariate analyses were applied to assess the effect of female gender on in-hospital outcomes over time.
Results: Unadjusted mortality for females (3.4% [8,763/257,728]) was higher compared to males (2.0% [5,155/257,728], p<0.001) undergoing isolated CABG operations. Female patients accrued longer hospital lengths of stay (10.6±8.7 days vs. 9.0±7.3, p<0.001) and higher total costs ($103,910±83,214, vs. $95,779±74,912, p<0.001) compared to males. From 2003 to 2007, the adjusted mortality improved by 28% (OR: 0.72, p<0.001). After controlling for patient and operative risk factors, females incurred a 63% (OR=1.63, p<0.001) higher risk of mortality compared to males. Importantly, when stratified by year, mortality for females has improved to a greater extent than that for males (p<0.001, Figure 1). The concomitant influence of female gender and year of operation, however, remained a significant predictor (p<0.001) of mortality.
Conclusions: Risk-adjusted mortality for coronary artery bypass grafting is improving. Although the impact of gender as a risk factor during CABG appears to be declining, female gender continues to be independently associated with death. Figure 1: In-Hospital Mortality for Female vs. Male Patients Undergoing Isolated CABG Operations by Operative Year (p<0.001).
- © 2010 by American Heart Association, Inc.