title: Sex differences in procedure selection and outcomes of patients undergoing mitral valve surgery.
abstract: BACKGROUND
  There is a paucity of data on sex differences in procedure selection and outcomes of patients undergoing mitral valve surgery.
  
  
  RESULTS
  The National Inpatient Sample database from 2005 to 2008 was searched to identify patients ≥30 years of age who underwent mitral valve repair or replacement (ICD-9-CM codes 35.12, 35.23, and 35.24). Women constituted 51.6% of the patients, and they were older, were less affluent, had higher values for the Charlson comorbidity index, and more often presented on an urgent/emergent basis. Women underwent repair less often than men (37.9% versus 55.9%, P < .001) and more often underwent concomitant tricuspid surgery or a Maze procedure. After adjustment for propensity scores, women were more likely to undergo replacement (odds ratio, 1.78; 95% confidence interval, 1.64-1.93; P = .0001), they had longer lengths of stay, and less favorable disposition. Among the patients who underwent mitral valve repair, women had a higher hospital mortality (2.06% versus 1.36%, P = .0328). After adjustment for propensity scores and concomitant procedures, this relationship was no longer statistically significant.
  
  
  CONCLUSIONS
  Women are less likely than men to receive mitral valve repair. Although the higher hospital mortality of women presenting for mitral valve surgery was accounted for by their worse preoperative profiles, this sex disparity reflects the current reality in surgical practice and identifies an important area for future improvement in the care of patients with valvular heart disease.
authors: Department of Surgery, Division of Cardiothoracic Surgery, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9638, USA. cvassileva@siumed.edu
authors: Christina M
authors: CM
authors: Vassileva
authors: Lacey M
authors: LM
authors: Stelle
authors: Steve
authors: S
authors: Markwell
authors: Theresa
authors: T
authors: Boley
authors: Stephen
authors: S
authors: Hazelrigg
mesh_terms: D000367:Age Factors; D000368:Aged; D016001:Confidence Intervals; D005260:Female; D006305:Health Status Indicators; D006349:Heart Valve Diseases / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D016017:Odds Ratio; D011183:Postoperative Complications; D057216:Propensity Score; D012307:Risk Factors; D012737:Sex Factors; D013223:Statistics as Topic; D016896:Treatment Outcome