Association of gender with morbidity and mortality after isolated coronary artery bypass grafting. A propensity score matched analysis

Mahboob Alam, Vei Vei Lee, McArthur A. Elayda, Saima A. Shahzad, Eric Y. Yang, Vijay Nambi, Hani Jneid, Wei Pan, Stephanie Coulter, James M. Wilson, K Ramanathan, Christie M. Ballantyne, Salim S. Virani

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Abstract

Introduction: There is conflicting evidence about the impact of gender on outcomes after coronary artery bypass grafting (CABG). Methods: We performed a multivariate logistic regression and propensity score matched analyses in 13,115 patients (75% men) who underwent CABG between January 1, 1995 and December 31, 2009. The primary outcome was in-hospital mortality. Secondary outcomes included post-operative respiratory failure, stroke, myocardial infarction, sternal and leg wound infections, atrial fibrillation (AF), renal failure, need for postoperative intra-aortic balloon pump (IABP) support, and length of hospital stay. Results: A higher proportion of women (184; 5.6%) suffered in-hospital death compared to men (264; 2.7%), p < 0.0001. After propensity score matching (n = 3600 total, 1800 in each group), female gender was an independent predictor of mortality after isolated CABG (odds ratio [OR] = 1.84; 95% confidence interval [CI] 1.22-2.78). Women also experienced a higher incidence of postoperative complications including stroke (3.8% vs. 2.3%, OR 1.37; 95% CI 1.08-1.73) and leg wound infection (3.4% vs. 1.7%, OR 1.75; 95% CI 1.36-2.54) on multivariate regression analyses. However, these differences were not significant after propensity score matching. We also observed a lower risk of post-operative AF (21.2% vs. 22.1%, OR 0.78; 95% CI 0.70-0.86) in women that remained significant after propensity matching (O.R. 0.76; 95% C.I. 0.65-0.90). Length of hospital stay was longer in women compared with men (11.9 ± 9.0 vs. 10.4 ± 9.2 days, p < 0.0001). Conclusions: Female gender is an independent predictor of increased mortality and a lower incidence of post-operative AF after isolated CABG.

Original languageEnglish (US)
Pages (from-to)180-184
Number of pages5
JournalInternational Journal of Cardiology
Volume167
Issue number1
DOIs
StatePublished - Jul 15 2013

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Propensity Score
Coronary Artery Bypass
Length of Stay
Odds Ratio
Confidence Intervals
Atrial Fibrillation
Morbidity
Mortality
Wound Infection
Leg
Stroke
Incidence
Hospital Mortality
Respiratory Insufficiency
Renal Insufficiency
Multivariate Analysis
Logistic Models
Myocardial Infarction
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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Association of gender with morbidity and mortality after isolated coronary artery bypass grafting. A propensity score matched analysis. / Alam, Mahboob; Lee, Vei Vei; Elayda, McArthur A.; Shahzad, Saima A.; Yang, Eric Y.; Nambi, Vijay; Jneid, Hani; Pan, Wei; Coulter, Stephanie; Wilson, James M.; Ramanathan, K; Ballantyne, Christie M.; Virani, Salim S.

In: International Journal of Cardiology, Vol. 167, No. 1, 15.07.2013, p. 180-184.

Research output: Contribution to journalArticle

Alam, M, Lee, VV, Elayda, MA, Shahzad, SA, Yang, EY, Nambi, V, Jneid, H, Pan, W, Coulter, S, Wilson, JM, Ramanathan, K, Ballantyne, CM & Virani, SS 2013, 'Association of gender with morbidity and mortality after isolated coronary artery bypass grafting. A propensity score matched analysis', International Journal of Cardiology, vol. 167, no. 1, pp. 180-184. https://doi.org/10.1016/j.ijcard.2011.12.047
Alam, Mahboob ; Lee, Vei Vei ; Elayda, McArthur A. ; Shahzad, Saima A. ; Yang, Eric Y. ; Nambi, Vijay ; Jneid, Hani ; Pan, Wei ; Coulter, Stephanie ; Wilson, James M. ; Ramanathan, K ; Ballantyne, Christie M. ; Virani, Salim S. / Association of gender with morbidity and mortality after isolated coronary artery bypass grafting. A propensity score matched analysis. In: International Journal of Cardiology. 2013 ; Vol. 167, No. 1. pp. 180-184.
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abstract = "Introduction: There is conflicting evidence about the impact of gender on outcomes after coronary artery bypass grafting (CABG). Methods: We performed a multivariate logistic regression and propensity score matched analyses in 13,115 patients (75{\%} men) who underwent CABG between January 1, 1995 and December 31, 2009. The primary outcome was in-hospital mortality. Secondary outcomes included post-operative respiratory failure, stroke, myocardial infarction, sternal and leg wound infections, atrial fibrillation (AF), renal failure, need for postoperative intra-aortic balloon pump (IABP) support, and length of hospital stay. Results: A higher proportion of women (184; 5.6{\%}) suffered in-hospital death compared to men (264; 2.7{\%}), p < 0.0001. After propensity score matching (n = 3600 total, 1800 in each group), female gender was an independent predictor of mortality after isolated CABG (odds ratio [OR] = 1.84; 95{\%} confidence interval [CI] 1.22-2.78). Women also experienced a higher incidence of postoperative complications including stroke (3.8{\%} vs. 2.3{\%}, OR 1.37; 95{\%} CI 1.08-1.73) and leg wound infection (3.4{\%} vs. 1.7{\%}, OR 1.75; 95{\%} CI 1.36-2.54) on multivariate regression analyses. However, these differences were not significant after propensity score matching. We also observed a lower risk of post-operative AF (21.2{\%} vs. 22.1{\%}, OR 0.78; 95{\%} CI 0.70-0.86) in women that remained significant after propensity matching (O.R. 0.76; 95{\%} C.I. 0.65-0.90). Length of hospital stay was longer in women compared with men (11.9 ± 9.0 vs. 10.4 ± 9.2 days, p < 0.0001). Conclusions: Female gender is an independent predictor of increased mortality and a lower incidence of post-operative AF after isolated CABG.",
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T1 - Association of gender with morbidity and mortality after isolated coronary artery bypass grafting. A propensity score matched analysis

AU - Alam, Mahboob

AU - Lee, Vei Vei

AU - Elayda, McArthur A.

AU - Shahzad, Saima A.

AU - Yang, Eric Y.

AU - Nambi, Vijay

AU - Jneid, Hani

AU - Pan, Wei

AU - Coulter, Stephanie

AU - Wilson, James M.

AU - Ramanathan, K

AU - Ballantyne, Christie M.

AU - Virani, Salim S.

PY - 2013/7/15

Y1 - 2013/7/15

N2 - Introduction: There is conflicting evidence about the impact of gender on outcomes after coronary artery bypass grafting (CABG). Methods: We performed a multivariate logistic regression and propensity score matched analyses in 13,115 patients (75% men) who underwent CABG between January 1, 1995 and December 31, 2009. The primary outcome was in-hospital mortality. Secondary outcomes included post-operative respiratory failure, stroke, myocardial infarction, sternal and leg wound infections, atrial fibrillation (AF), renal failure, need for postoperative intra-aortic balloon pump (IABP) support, and length of hospital stay. Results: A higher proportion of women (184; 5.6%) suffered in-hospital death compared to men (264; 2.7%), p < 0.0001. After propensity score matching (n = 3600 total, 1800 in each group), female gender was an independent predictor of mortality after isolated CABG (odds ratio [OR] = 1.84; 95% confidence interval [CI] 1.22-2.78). Women also experienced a higher incidence of postoperative complications including stroke (3.8% vs. 2.3%, OR 1.37; 95% CI 1.08-1.73) and leg wound infection (3.4% vs. 1.7%, OR 1.75; 95% CI 1.36-2.54) on multivariate regression analyses. However, these differences were not significant after propensity score matching. We also observed a lower risk of post-operative AF (21.2% vs. 22.1%, OR 0.78; 95% CI 0.70-0.86) in women that remained significant after propensity matching (O.R. 0.76; 95% C.I. 0.65-0.90). Length of hospital stay was longer in women compared with men (11.9 ± 9.0 vs. 10.4 ± 9.2 days, p < 0.0001). Conclusions: Female gender is an independent predictor of increased mortality and a lower incidence of post-operative AF after isolated CABG.

AB - Introduction: There is conflicting evidence about the impact of gender on outcomes after coronary artery bypass grafting (CABG). Methods: We performed a multivariate logistic regression and propensity score matched analyses in 13,115 patients (75% men) who underwent CABG between January 1, 1995 and December 31, 2009. The primary outcome was in-hospital mortality. Secondary outcomes included post-operative respiratory failure, stroke, myocardial infarction, sternal and leg wound infections, atrial fibrillation (AF), renal failure, need for postoperative intra-aortic balloon pump (IABP) support, and length of hospital stay. Results: A higher proportion of women (184; 5.6%) suffered in-hospital death compared to men (264; 2.7%), p < 0.0001. After propensity score matching (n = 3600 total, 1800 in each group), female gender was an independent predictor of mortality after isolated CABG (odds ratio [OR] = 1.84; 95% confidence interval [CI] 1.22-2.78). Women also experienced a higher incidence of postoperative complications including stroke (3.8% vs. 2.3%, OR 1.37; 95% CI 1.08-1.73) and leg wound infection (3.4% vs. 1.7%, OR 1.75; 95% CI 1.36-2.54) on multivariate regression analyses. However, these differences were not significant after propensity score matching. We also observed a lower risk of post-operative AF (21.2% vs. 22.1%, OR 0.78; 95% CI 0.70-0.86) in women that remained significant after propensity matching (O.R. 0.76; 95% C.I. 0.65-0.90). Length of hospital stay was longer in women compared with men (11.9 ± 9.0 vs. 10.4 ± 9.2 days, p < 0.0001). Conclusions: Female gender is an independent predictor of increased mortality and a lower incidence of post-operative AF after isolated CABG.

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