title: Association of gender with morbidity and mortality after isolated coronary artery bypass grafting. A propensity score matched analysis.
abstract: BACKGROUND
  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.
authors.affiliation: Memphis Veterans Affairs Medical Center, and University of Tennessee Health Sciences Center 1030 Jefferson Avenue, Memphis, TN 38104, USA. mahboob02@gmail.com
authors.forename: Mahboob
authors.initials: M
authors.lastname: Alam
authors.forename: Vei-Vei
authors.initials: VV
authors.lastname: Lee
authors.forename: McArthur A
authors.initials: MA
authors.lastname: Elayda
authors.forename: Saima A
authors.initials: SA
authors.lastname: Shahzad
authors.forename: Eric Y
authors.initials: EY
authors.lastname: Yang
authors.forename: Vijay
authors.initials: V
authors.lastname: Nambi
authors.forename: Hani
authors.initials: H
authors.lastname: Jneid
authors.forename: Wei
authors.initials: W
authors.lastname: Pan
authors.forename: Stephanie
authors.initials: S
authors.lastname: Coulter
authors.forename: James M
authors.initials: JM
authors.lastname: Wilson
authors.forename: Kodangudi B
authors.initials: KB
authors.lastname: Ramanathan
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.forename: Salim S
authors.initials: SS
authors.lastname: Virani
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000401:mortality* / Q000639:trends; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality*; D057216:Propensity Score; D012189:Retrospective Studies; D012307:Risk Factors; D012727:Sex Characteristics