Sex differences in outcomes following isolated coronary artery bypass graft surgery in Australian patients: Analysis of the Australasian Society of Cardiac and Thoracic Surgeons cardiac surgery database
Objectives: Women undergoing isolated coronary artery bypass graft (CABG) surgery have been previously shown to be at an independently increased risk for post-operative morbidity and mortality. The current study evaluates the impact of sex as an independent risk factor for early and late morbidity a...
| Main Authors: | , , , , , |
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| Format: | Journal Article |
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2012
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| Online Access: | http://hdl.handle.net/20.500.11937/27082 |
| _version_ | 1848752164854300672 |
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| author | Saxena, A. Dinh, D. Smith, J. Shardey, G. Reid, Christopher Newcomb, A. |
| author_facet | Saxena, A. Dinh, D. Smith, J. Shardey, G. Reid, Christopher Newcomb, A. |
| author_sort | Saxena, A. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objectives: Women undergoing isolated coronary artery bypass graft (CABG) surgery have been previously shown to be at an independently increased risk for post-operative morbidity and mortality. The current study evaluates the impact of sex as an independent risk factor for early and late morbidity and mortality following isolated CABG surgery. Methods: Data obtained between June 2001 and December 2009 by the Australasian Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database Program was retrospectively analysed. Demographic, operative data and post-operative complications were compared between male and female patients using chi-square and t-tests. Long-term survival analysis was performed using Kaplan-Meier survival curves and the log-rank test. Independent risk factors for short- and long-term mortality were identified using binary logistic and Cox regression, respectively. Results: CABG surgery was undertaken in 21 534 patients at 18 Australian institutions; 22.2% were female. Female patients were generally older (mean age, 68 vs. 65 years, P < 0.001) and presented more often with congestive heart failure (P < 0.001), hypertension (P < 0.001), diabetes mellitus (P < 0.001) and cerebrovascular disease (P < 0.001). Women demonstrated a greater 30-day mortality (2.2% vs. 1.5%, P < 0.001) on univariate analysis but not on multivariate analysis (P = 0.638). Similarly, women demonstrated a greater late mortality than men on univariate analysis (P = 0.006) but not on multivariate analysis (P = 0.093). Women had a decreased risk of early complications including new renal failure (P = 0.001) and deep sternal wound infection (P = 0.017) but were more likely to require red blood cell transfusion (P < 0.001). Conclusions: Female patients undergoing isolated CABG surgery have a greater 30-day mortality which may be accounted for by a poorer pre-operative risk factor profile. Further investigation is required into the reasons for differential outcome after CABG based on sex. © The Author 2012. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. |
| first_indexed | 2025-11-14T08:04:16Z |
| format | Journal Article |
| id | curtin-20.500.11937-27082 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T08:04:16Z |
| publishDate | 2012 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-270822017-09-13T15:31:14Z Sex differences in outcomes following isolated coronary artery bypass graft surgery in Australian patients: Analysis of the Australasian Society of Cardiac and Thoracic Surgeons cardiac surgery database Saxena, A. Dinh, D. Smith, J. Shardey, G. Reid, Christopher Newcomb, A. Objectives: Women undergoing isolated coronary artery bypass graft (CABG) surgery have been previously shown to be at an independently increased risk for post-operative morbidity and mortality. The current study evaluates the impact of sex as an independent risk factor for early and late morbidity and mortality following isolated CABG surgery. Methods: Data obtained between June 2001 and December 2009 by the Australasian Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database Program was retrospectively analysed. Demographic, operative data and post-operative complications were compared between male and female patients using chi-square and t-tests. Long-term survival analysis was performed using Kaplan-Meier survival curves and the log-rank test. Independent risk factors for short- and long-term mortality were identified using binary logistic and Cox regression, respectively. Results: CABG surgery was undertaken in 21 534 patients at 18 Australian institutions; 22.2% were female. Female patients were generally older (mean age, 68 vs. 65 years, P < 0.001) and presented more often with congestive heart failure (P < 0.001), hypertension (P < 0.001), diabetes mellitus (P < 0.001) and cerebrovascular disease (P < 0.001). Women demonstrated a greater 30-day mortality (2.2% vs. 1.5%, P < 0.001) on univariate analysis but not on multivariate analysis (P = 0.638). Similarly, women demonstrated a greater late mortality than men on univariate analysis (P = 0.006) but not on multivariate analysis (P = 0.093). Women had a decreased risk of early complications including new renal failure (P = 0.001) and deep sternal wound infection (P = 0.017) but were more likely to require red blood cell transfusion (P < 0.001). Conclusions: Female patients undergoing isolated CABG surgery have a greater 30-day mortality which may be accounted for by a poorer pre-operative risk factor profile. Further investigation is required into the reasons for differential outcome after CABG based on sex. © The Author 2012. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2012 Journal Article http://hdl.handle.net/20.500.11937/27082 10.1093/ejcts/ezr039 unknown |
| spellingShingle | Saxena, A. Dinh, D. Smith, J. Shardey, G. Reid, Christopher Newcomb, A. Sex differences in outcomes following isolated coronary artery bypass graft surgery in Australian patients: Analysis of the Australasian Society of Cardiac and Thoracic Surgeons cardiac surgery database |
| title | Sex differences in outcomes following isolated coronary artery bypass graft surgery in Australian patients: Analysis of the Australasian Society of Cardiac and Thoracic Surgeons cardiac surgery database |
| title_full | Sex differences in outcomes following isolated coronary artery bypass graft surgery in Australian patients: Analysis of the Australasian Society of Cardiac and Thoracic Surgeons cardiac surgery database |
| title_fullStr | Sex differences in outcomes following isolated coronary artery bypass graft surgery in Australian patients: Analysis of the Australasian Society of Cardiac and Thoracic Surgeons cardiac surgery database |
| title_full_unstemmed | Sex differences in outcomes following isolated coronary artery bypass graft surgery in Australian patients: Analysis of the Australasian Society of Cardiac and Thoracic Surgeons cardiac surgery database |
| title_short | Sex differences in outcomes following isolated coronary artery bypass graft surgery in Australian patients: Analysis of the Australasian Society of Cardiac and Thoracic Surgeons cardiac surgery database |
| title_sort | sex differences in outcomes following isolated coronary artery bypass graft surgery in australian patients: analysis of the australasian society of cardiac and thoracic surgeons cardiac surgery database |
| url | http://hdl.handle.net/20.500.11937/27082 |