Gender differences in mortality following non-cardiovascular surgery: an observational study

Area of Science:

• Surgery
• Anesthesiology
• Public Health

Background:

• Sex-based disparities in cardiovascular surgery are known.
• Limited research exists on sex differences in non-cardiovascular surgery mortality.

Purpose of the Study:

• To investigate sex differences in mortality after non-cardiovascular surgery.
• To determine if preoperative risk factors explain observed mortality differences between males and females.

Main Methods:

• Observational study of 39,433 non-cardiovascular inpatient surgical cases (2003-2009).
• Data sourced from institutional Electronic Data Warehouse.
• Primary outcome: 30-day in-hospital mortality; analyzed using logistic regression.

Main Results:

• 30-day mortality was 2.76% for males vs. 1.89% for females (OR, 1.47).
• Age, comorbidities, American Society of Anesthesiologists (ASA) classification, and emergent status predicted mortality.
• After risk factor adjustment, the male mortality OR decreased to 1.31.

Conclusions:

• Males had higher ASA classification, more comorbidities, and more emergent cases than females.
• These factors partially explain the increased mortality observed in males.
• Sex differences in presentation and risk factors contribute to non-cardiovascular surgery outcomes.