Is Female Gender Associated with Mortality in Coronary Artery Bypass Grafting?

Area of Science:

• Cardiovascular Surgery
• Health Services Research
• Gender Health Disparities

Background:

• Women undergoing coronary artery bypass grafting (CABG) historically exhibit worse in-hospital outcomes compared to men.
• The underlying reasons for these disparities, whether attributable to gender alone or specific clinical factors, remain incompletely understood.

Purpose of the Study:

• To conduct a comparative analysis of in-hospital outcomes between female and male patients undergoing CABG.
• To investigate the independent impact of female gender on mortality and length of stay after CABG.

Main Methods:

• A retrospective observational study analyzed data from 9,845 patients (19.8% women) who underwent CABG between 1995 and 2022 at a single center.
• Statistical analyses included descriptive statistics, univariate and multivariate logistic regression, and propensity score matching to evaluate female gender as a prognostic factor for in-hospital mortality.

Main Results:

• Women were older, had lower BMI, and a higher prevalence of diabetes. They experienced longer hospital stays and higher operative mortality rates.
• Initial logistic regression indicated female gender was associated with increased mortality (OR=1.51; p=0.003).
• However, after propensity score matching to control for clinical factors, the difference in mortality between genders became statistically insignificant (OR=1.20; p=0.241), though women still had longer hospital stays.

Conclusions:

• The observed disparity in in-hospital mortality for women undergoing CABG is largely eliminated when accounting for clinical differences between sexes.
• These findings underscore the importance of addressing clinical disparities to potentially improve mortality outcomes for women undergoing this procedure.
• Targeted interventions focused on mitigating these clinical factors may be crucial for enhancing care equity and results in female CABG patients.