Women undergoing coronary artery bypass surgery: physiological and psychosocial perspectives

Men and women have similar mortality and long-term survival after coronary artery bypass surgery. When compared with men, however, women have less favorable outcomes in graft patency, perioperative infarction, relief of symptoms, and physical activity levels. Finally, little information is available about women's employment and psychosocial outcomes, making comparisons between genders speculative at best. We suggest that prospective studies of bypass surgery in women include a thorough assessment of key variables such as symptoms, activity, and return to employment, housework, or both, before and after surgery. It is essential to examine the immediate postoperative activity level of female bypass surgery patients for information on resumption of household activities. This information is critical for successful rehabilitation. Whether the term "return to work" includes household activities must be addressed. This will allow researchers to use the same outcome when discussing "gainfully employed or active." For comparisons between the sexes, women of all age groups must be studied, since age clearly affects outcome. The effect of repeated surgeries must also be examined. As more women survive the first bypass, how they fare in subsequent operations will require study. The need to examine benefits of surgical versus medical treatment is critical. A primary issue is whether women are referred for surgical intervention later than men, and if so, is this a reason for their relatively poor outcome after this procedure? Furthermore, we predict that the multiple roles now assumed by women will influence incidence of heart disease and how women fare after surgical intervention.(ABSTRACT TRUNCATED AT 250 WORDS)