title: Gender differences in patients undergoing surgery for acute type A aortic dissection.
abstract: OBJECTIVE
  The impact of gender on preoperative characteristics and postoperative outcomes in patients undergoing surgery for acute type A aortic dissection rarely has been investigated.
  
  
  METHODS
  We reviewed the records of 504 patients (245 women and 259 men) who underwent surgery for acute type A aortic dissection between August 2006 and December 2013. Women were older (71.5 vs 59.7 years; P < .001) and smaller (body surface area 1.5 vs 1.9 m(2); P < .001) than men. Early and long-term outcomes were compared between men and women.
  
  
  RESULTS
  Operative mortality (<30 days) was similar between the groups (4.5% vs 5.8%; P = .646). Multivariable logistic regression analysis demonstrated that myocardial ischemia (odds ratio [OR], 5.48; 95% confidence interval [CI], 2.00-15.00; P < .001), neurologic ischemia (OR, 6.64; 95% CI, 2.26-19.48; P < .001), and shock/tamponade (OR, 3.74; 95% CI, 1.49-9.40; P = .005) were independent predictors of operative mortality. At 5 years, there was no significant difference in survival between the groups (80.1% vs 89.3%; P = .067). Cox regression analysis demonstrated that myocardial ischemia (hazard ratio [HR], 2.40; 95% CI, 1.21-4.74; P = .012), nonprescription of beta-blockers at discharge (HR, 4.27; 95% CI, 2.43-7.50; P < .001), and nonprescription of angiotensin II receptor blockers at discharge (HR, 2.39; 95% CI, 1.14-5.01; P = .021) were independent predictors of late mortality. Female gender was not an independent predictor of operative and late mortality.
  
  
  CONCLUSIONS
  There are no differences in early and long-term outcomes between male and female patients undergoing surgery for acute type A aortic dissection.
authors.affiliation: Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan. Electronic address: tfukui.cvs@gmail.com.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Fukui
authors.affiliation: Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan; Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Tabata
authors.affiliation: Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.affiliation: Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Takanashi
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001830:Body Surface Area; D018572:Disease-Free Survival; D005260:Female; D054624:Health Status Disparities; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality
keywords: aorta; aortic dissection; aortic surgery; sex; surgery