Is the female gender an independent predictor of adverse outcome after off-pump coronary artery bypass grafting?
BACKGROUND
The female gender is an independent predictor of adverse outcome after conventional coronary artery bypass grafting using cardiopulmonary bypass. The aim of this study is to assess the effect of the female gender on the outcome after off-pump coronary artery bypass (OPCAB) surgery.


METHODS
This study is a retrospective review of 413 consecutive patients (181 women and 232 men) who underwent OPCAB between January 1999 and May 2001. Adverse outcomes were divided into minor adverse outcomes (MINAO), major adverse outcomes (MAJAO), and prolonged length of stay (PLOS) more than 7 days. MINAO included atrial fibrillation, respiratory complications except adult respiratory distress syndrome, and any wound infection except mediastinitis. MAJAO included stroke, myocardial infarction, renal failure, adult respiratory distress syndrome, mediastinitis, low cardiac output, mechanical ventilation more than 24 hours, intensive therapy unit stay more than 24 hours, gastrointestinal complications, cardiorespiratory arrest, and mortality within 30 days. Preoperative and intraoperative variables were evaluated as predictors of MINAO, MAJAO, and PLOS by univariate and multivariate analyses.


RESULTS
The groups were matched for age and Parsonnet score-predicted mortality. However, the women had a higher incidence of chronic obstructive airway disease (p = 0.04), diabetes (p = 0.01), obesity (p = 0.000), peripheral vascular disease (p = 0.000), hypertension (p = 0.000), unstable angina (p = 0.005), history of previous failed nonsurgical intervention (p = 0.02), and nonelective operation (p = 0.000). There were a fewer number of grafts performed in the female group (2.8 vs 3.4, p = 0.000), with the circumflex territory being revascularised less frequently (p = 0.001). Univariate analysis identified the female gender to be a predictor of only MINAO (p = 0.001) and PLOS (p = 0.000). However, with multivariate analysis, female gender was not found to be an independent predictor of MINAO, MAJAO, or PLOS.


CONCLUSIONS
In OPCAB, the female gender is not an independent predictor of MINAO, MAJAO, or PLOS.
Athanasiou
Thanos
T
The National Heart and Lung Institute, Imperial College of Science, Technology and Medicine, Harefield Hospital, Middlesex, United Kingdom.
Al-Ruzzeh
Sharif
S
Del Stanbridge
Rex
R
Casula
Roberto P
RP
Glenville
Brian E
BE
Amrani
Mohamed
M
D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome