Coronary Artery DiseaseEffect of Gender and Race on Operative Mortality After Isolated Coronary Artery Bypass Grafting
Section snippets
Methods
This retrospective cohort study included all consecutive patients who underwent isolated CABG at Baylor University Medical Center in Dallas, Texas, from January 2004 to October 2011. Patients with previous valve surgery, preoperative endocarditis, and/or ventricular assist devices were excluded. The final study cohort included 8,154 consecutive patients. Data routinely collected by Baylor University Medical Center for the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database14, 15,
Results
There were a total of 226 (2.77%) operative deaths in the cohort. Unadjusted operative mortality is listed by gender in Table 1 and by race in Table 2. Figure 1 shows the predicted propensity-adjusted probabilities for post-CABG operative mortality for gender and for race. No effect modification was found between gender, race and ethnicity, type of bypass (off-pump vs on-pump) surgery, or elective versus urgent or emergent CABG. The propensity-adjusted analysis showed strong evidence of
Discussion
In this 8-year, single-center cohort, we observed significantly higher risk-adjusted operative mortality for women compared with men but no significant differences among different races and ethnicities. With regard to gender, our results support previous findings that indicate female gender independently increases the risk for operative mortality in CABG, including a meta-analysis of nearly 1 million CABG patients that found 77% greater odds of short-term mortality for women compared to men
Disclosures
The authors have no conflicts of interest to disclose.
References (29)
- et al.
Comparison by meta-analysis of mortality after isolated coronary artery bypass grafting in women versus men
Am J Cardiol
(2013) - et al.
The influence of gender on the outcome of coronary artery bypass surgery
Ann Thorac Surg
(2000) - et al.
Operative mortality in women and men undergoing coronary artery bypass grafting (from the California Coronary Artery Bypass Grafting Outcomes Reporting Program)
Am J Cardiol
(2010) - et al.
The effect of race on coronary bypass operative mortality
J Am Coll Cardiol
(2000) - et al.
Effects of race, with or without gender, on operative mortality after coronary artery bypass grafting: a study using the Society of Thoracic Surgeons National Database
Ann Thorac Surg
(2001) - et al.
Impact of hospital volume on racial disparities in cardiovascular procedure mortality
J Am Coll Cardiol
(2006) - et al.
Clinical characteristics and 30-day mortality among Caucasians, Hispanics, Asians, and African-Americans in the 2003 California coronary artery bypass graft surgery outcomes reporting program
Am J Cardiol
(2007) - et al.
The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 1—coronary artery bypass grafting surgery
Ann Thorac Surg
(2009) - et al.
The STS national database: current changes and challenges for the new millennium. Committee to Establish a National Database in Cardiothoracic Surgery, the Society of Thoracic Surgeons
Ann Thorac Surg
(2000) - et al.
Categorizing BMI may lead to biased results in studies investigating in-hospital mortality after isolated CABG
J Clin Epidemiol
(2007)
Prevalence of risk factors, and not gender per se, determines short- and long-term survival after coronary artery bypass surgery
J Cardiothorac Vasc Anesth
Differences in the management and prognosis of women and men who suffer from acute coronary syndromes
J Am Coll Cardiol
Myocardium at risk is associated with adverse clinical events in women but not in men, after coronary artery bypass grafting
Can J Cardiol
Coronary microvascular dysfunction is highly prevalent in women with chest pain in the absence of coronary artery disease: results from the NHLBI WISE study
Am Heart J
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This work was funded in part by the Bradley Family Endowment to the Baylor Health Care System Foundation, Dallas, Texas, The Baylor Health Care System Cardiovascular Research Committee, Dallas, Texas, and the Discovery Foundation, Dallas, Texas.
See page 617 for disclosure information.