Sex-specific disparities in patients undergoing isolated CABG

Area of Science:

• Cardiovascular Surgery
• Health Services Research
• Sex Differences in Medicine

Background:

• Coronary artery bypass grafting (CABG) is a common cardiac procedure.
• Understanding sex-specific differences in CABG outcomes is crucial for equitable patient care.

Purpose of the Study:

• To examine sex-specific characteristics and outcomes in patients undergoing coronary artery bypass grafting (CABG).
• To identify risk factors associated with mortality in female CABG patients.

Main Methods:

• Retrospective chart review of the institutional Society of Thoracic Surgeons (STS) database from 2010 to 2021.
• Analysis included preoperative, intraoperative, and postoperative variables for 3163 females and 9573 males undergoing isolated CABG.
• Univariate and multivariate logistic regression analyses were used to compare groups and assess risk factors for 30-day mortality.

Main Results:

• Females presented with more preoperative comorbidities and underwent more urgent/emergent CABG procedures compared to males.
• Females experienced longer intensive care unit (ICU) stays and higher in-hospital and 30-day mortality rates.
• Female sex was identified as an independent risk factor for 30-day mortality (OR=1.46, 95% CI: 1.06-2.03).

Conclusions:

• Over the past decade, females undergoing CABG exhibited greater preoperative morbidity, more urgent procedures, longer ICU stays, and increased mortality risk compared to males.
• These findings highlight significant sex-based disparities in CABG outcomes.
• Further research is warranted to investigate these disparities and improve outcomes for female patients undergoing CABG.