TY - JOUR
T1 - Female sex as an independent predictor of morbidity and survival after isolated coronary artery bypass grafting
AU - Ahmed, Waleed
AU - Tully, Phillip
AU - Knight, John
AU - Baker, Robert
PY - 2011/7
Y1 - 2011/7
N2 - Background: This study sought to determine whether female sex was an independent risk factor for combined in-hospital morbidity, mortality, and long-term survival after coronary artery bypass grafting (CABG). Methods: Data were collected prospectively for 1,114 (23.5%) women and 3,628 (76.5%) men operated on between January 1, 1996 and December 31, 2004 with median follow-up of 7.9 years (interquartile range 3.55 to 10.5). The combined morbidity end point was defined as in-hospital renal failure, stroke, ventilation for more than 24 hours, deep sternal wound infection, reoperation, myocardial infarction (MI), and mortality less than 30 days after discharge. The long-term all-cause and cardiac mortality outcomes were analyzed using multivariate proportional hazard regression. Results: Females were older, with lower body surface area, and generally had more significant comorbid conditions than did males (p < 0.05). Female sex was associated with increased odds of the combined morbidity end point (adjusted odds ratio [OR] = 1.29; 95% confidence interval, 1.04 to 1.59, p = 0.02). There were 868 deaths (18.3% of total sample) during the follow-up period, and 305 deaths (n = 305 [35.1%] of deaths) were deemed to be of cardiac causes. In adjusted survival models, female sex was associated with cardiac mortality (hazard ratio [HR] = 1.28; 95% confidence interval, 0.96 to 1.73; p = 0.10) but not with all-cause mortality (HR = 0.92; 95% confidence interval, 0.77 to 1.11; p = 0.38). Conclusions: Female sex was associated with early combined morbidity and long-term cardiac mortality but not long-term all-cause mortality. A greater proportion of concomitant risk factors characterize female patients undergoing CABG.
AB - Background: This study sought to determine whether female sex was an independent risk factor for combined in-hospital morbidity, mortality, and long-term survival after coronary artery bypass grafting (CABG). Methods: Data were collected prospectively for 1,114 (23.5%) women and 3,628 (76.5%) men operated on between January 1, 1996 and December 31, 2004 with median follow-up of 7.9 years (interquartile range 3.55 to 10.5). The combined morbidity end point was defined as in-hospital renal failure, stroke, ventilation for more than 24 hours, deep sternal wound infection, reoperation, myocardial infarction (MI), and mortality less than 30 days after discharge. The long-term all-cause and cardiac mortality outcomes were analyzed using multivariate proportional hazard regression. Results: Females were older, with lower body surface area, and generally had more significant comorbid conditions than did males (p < 0.05). Female sex was associated with increased odds of the combined morbidity end point (adjusted odds ratio [OR] = 1.29; 95% confidence interval, 1.04 to 1.59, p = 0.02). There were 868 deaths (18.3% of total sample) during the follow-up period, and 305 deaths (n = 305 [35.1%] of deaths) were deemed to be of cardiac causes. In adjusted survival models, female sex was associated with cardiac mortality (hazard ratio [HR] = 1.28; 95% confidence interval, 0.96 to 1.73; p = 0.10) but not with all-cause mortality (HR = 0.92; 95% confidence interval, 0.77 to 1.11; p = 0.38). Conclusions: Female sex was associated with early combined morbidity and long-term cardiac mortality but not long-term all-cause mortality. A greater proportion of concomitant risk factors characterize female patients undergoing CABG.
UR - http://www.scopus.com/inward/record.url?scp=79959788693&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2011.02.033
DO - 10.1016/j.athoracsur.2011.02.033
M3 - Article
SN - 0003-4975
VL - 92
SP - 59
EP - 67
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 1
ER -