title: Cardiac surgery in dialysis-dependent patients: impact of gender on early outcome in single-center experience with 204 consecutive cases.
abstract: BACKGROUND
  This study evaluates the impact of gender in dialysis-dependent patients undergoing cardiac surgery.
  
  
  METHODS
  We retrospectively identified 204 dialysis-dependent patients (68.6% male, aged 66.6 ± 9.9 years) with end-stage renal disease undergoing cardiac surgery and compared them to a propensity-score-pair-matched control collective.
  
  
  RESULTS
  A 30-day mortality was 13.2% (14/106) for coronary artery bypass grafting (CABG), 19.3% (6/31) for aortic valve replacement (AVR), and 23.8% (16/67) for combined procedures. Postoperative chest tube output was significantly higher in men (1,007 ± 946 mL) versus women (687 ± 598 mL, p = 0.014). Compared with a propensity-score-pair-matched control collective of 204 patients, we identified significant differences in terms of 30-day mortality: overall mortality revealed 17.6 versus 4.6% (p = 0.0001), 13.2 versus 3.4% (p = 0.014) for CABG, 19.3 versus 0% (p = 0.051) for AVR, and 23.8 versus 9.1% (p = 0.02) for combined procedures.
  
  
  CONCLUSIONS
  Multivariate analysis identified preoperative myocardial infarction, prolonged extracorporeal circulation time, operation time, and surgical reexploration as independent predictors of 30-day mortality. There was a higher occurrence of bleeding complications in men that remained significant even after correction for body surface area.
authors.affiliation: Department of Cardiac Surgery, Clinic Bogenhausen, City Hospital Munich, Munich, Germany. od120@gmx.de
authors.forename: Oliver
authors.initials: O
authors.lastname: Deutsch
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Spiliopoulos
authors.forename: Theodor
authors.initials: T
authors.lastname: Kiask
authors.forename: Elpiniki
authors.initials: E
authors.lastname: Katsari
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rippinger
authors.forename: Walter
authors.initials: W
authors.lastname: Eichinger
authors.forename: Birgitte
authors.initials: B
authors.lastname: Gansera
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D005858:Germany; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D057216:Propensity Score; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome