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Gender and functional outcome after coronary artery bypass
R D Stewart1, J L Blair, C E Emond
1Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass., USA.
Insights
Women undergoing coronary artery bypass graft (CABG) surgery start with lower functional status but experience similar improvements as men six months post-operation. This suggests gender does not impact functional recovery after CABG.
Area of Science:
- Cardiovascular Surgery
- Surgical Outcomes
- Gender Disparities in Medicine
Background:
- Female gender is a known risk factor for adverse outcomes following coronary artery bypass graft (CABG) surgery.
- The effect of gender on functional recovery after CABG is not well understood.
Purpose of the Study:
- To investigate the impact of gender on functional status and recovery after isolated primary CABG.
- To compare functional outcomes between female and male patients undergoing CABG.
Main Methods:
- Assessed functional status using the Duke Activity Status Index (DASI) at baseline and 6 months post-CABG.
- Included 196 consecutive patients undergoing isolated primary CABG; 158 (81%) had complete follow-up data.
- Compared DASI scores and functional improvement between 54 female and 104 male patients.
Main Results:
- Women had significantly lower DASI scores at baseline (19.3 vs 28.3, P=.001) and 6 months (22.7 vs 32.8, P=.0007).
- The change in DASI score from baseline to 6 months was comparable between genders (3.3 vs 4.5, P=.7).
- Similar proportions of women (54%) and men (53%) showed functional improvement above their baseline levels.
Conclusions:
- Women undergoing CABG present with a lower functional level compared to men.
- Despite initial differences, the functional improvement after CABG is similar for both genders.
- Gender does not appear to be a significant factor in the degree of functional recovery post-CABG.
Background:
Female gender is an established risk factor for increased mortality and morbidity after coronary artery bypass graft (CABG) surgery. However, the impact of gender on functional outcome after CABG is not well established.
Methods:
Functional status was assessed at baseline and at 6 months with the Duke Activity Status Index (DASI) in 196 consecutive patients undergoing isolated primary CABG. Follow-up data were complete in 158 (81%) patients. The functional status of the 54 (34%) female and the 104 (66%) male patients was compared.
Results:
The mean DASI score was significantly lower in women at baseline (19.3 +/- 13.8 vs 28.3 +/- 16.8, P = .001) and at 6 months (22.7 +/- 16.3 vs 32.8 +/- 18.2, P = .0007); however, the 6-month change in DASI score (3.3 +/- 16.9 vs 4.5 +/- 20.0, P = .7) was comparable. A similar proportion of women and men (54% vs 53%) had improved above their baseline functional level at 6 months.
Conclusions:
These data demonstrate that women undergo CABG at a significantly lower functional level than men; however, the functional improvement after CABG is similar across genders.