title: Gender does not impact infrainguinal vein bypass graft outcome.
abstract: BACKGROUND
  The percentage of women requiring infrainguinal bypass graft operations continues to increase, whereas the effect of gender on postoperative outcome remains unclear. The purpose of this study was to assess the influence of gender on patient selection and outcome in patients requiring infrainguinal vein bypass grafting procedures.
  
  
  METHODS
  This retrospective study reviewed 217 infrainguinal vein bypass grafts performed over an 8-year period. Medical records and patient interviews were used to determine study measures and outcomes. Gender and multiple covariables affecting patient survival were analyzed; postoperative complications and graft patencies were examined. Bivariate and life-table analyses were conducted, followed by multivariate analysis with the Cox proportional hazards model.
  
  
  RESULTS
  No statistical differences existed between men and women for age, diabetes, cardiac disease, tobacco use, hypertension, stroke, renal disease, or prior contralateral bypass or major amputation. Women were more likely to be black (P =.014) and have a spliced vein graft (P =.035). No differences were noted between the 2 groups for 30-day morbidity rates-except women had more incisional complications (P =.01)-or for survival (P =.45), primary-patency (P =.57), secondary-patency (P =. 79), or limb-salvage rates (P =.40). Multivariate analysis showed that gender had no role in affecting survival rates.
  
  
  CONCLUSIONS
  Gender does not affect graft patency, limb salvage, or survival rates. There should be no introduction of a gender bias into management of infrainguinal occlusive disease.
authors.affiliation: Section of Vascular Surgery, Yale University School of Medicine, New Haven, CT 06520, USA.
authors.forename: S G
authors.initials: SG
authors.lastname: Frangos
authors.forename: S
authors.initials: S
authors.lastname: Karimi
authors.forename: M D
authors.initials: MD
authors.lastname: Kerstein
authors.forename: M
authors.initials: M
authors.lastname: Harpavat
authors.forename: B
authors.initials: B
authors.lastname: Sumpio
authors.forename: A B
authors.initials: AB
authors.lastname: Roberts
authors.forename: V
authors.initials: V
authors.lastname: Gahtan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D005260:Female; D006801:Humans; D007264:Inguinal Canal; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate; D016896:Treatment Outcome; D014680:Veins / Q000601:surgery