Applying the Gender Lens to Risk Factors and Outcome after Adult Cardiac Surgery.
BACKGROUND
Applying the gender lens to risk factors and outcome after adult cardiac surgery is of major clinical interest, as the inclusion of sex and gender in research design and analysis may guarantee more comprehensive cardiovascular science and may consecutively result in a more effective surgical treatment as well as cost savings in cardiac surgery.


METHODS
We have reviewed classical cardiovascular risk factors (diabetes, arterial hypertension, hyperlipidemia, smoking) according to a gender-based approach. Furthermore, we have examined comorbidities such as depression, renal insufficiency, and hormonal influences in regard to gender. Gender-sensitive economic aspects have been evaluated, surgical outcome has been analyzed, and cardiovascular research has been considered from a gender perspective.


RESULTS
The influence of typical risk factors and outcome after cardiac surgery has been evaluated from a gender perspective, and the gender-specific distribution of these risk factors is reported on. The named comorbidities are listed. Economic aspects demonstrated a gender gap. Outcome after coronary and valvular surgeries as well as after heart transplantation are displayed in this regard. Results after postoperative use of intra-aortic balloon pump are shown. Gender-related aspects of clinical and biomedical cardiosurgical research are reported.


CONCLUSIONS
Female gender has become an independent risk factor of survival after the majority of cardiosurgical procedures. Severely impaired left ventricular ejection fraction independently predicts survival in men, whereas age does in females.
Klinik für Herzchirurgie, Herzzentrum Leipzig, Universität Leipzig, Frankfurt/M., Germany.
Sandra
S
Eifert
Klinik für Herzchirurgie, Ludwig-Maximilians-Universität München, Frankfurt/M., Germany.
Sonja
S
Guethoff
Klinik für Herzchirurgie, Ludwig-Maximilians-Universität München, Frankfurt/M., Germany.
Ingo
I
Kaczmarek
Klinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Goethe-Universität, Frankfurt/M., Germany.
Andres
A
Beiras-Fernandez
Institut für Geschlechterforschung in der Medizin (GiM), Charité - Universitätsmedizin, Campus Mitte, Berlin, Germany.
Ute
U
Seeland
Klinik und Poliklinik für Herz- und Gefäßchirurgie, Universitäres Herzzentrum Hamburg, Germany.
Helmut
H
Gulbins
Klinik für Herzchirurgie, Herzzentrum Leipzig, Universität Leipzig, Frankfurt/M., Germany.
Jörg
J
Seeburger
Klinik für Herzchirurgie, Klinikum Bogenhausen, Städtisches Klinikum München, Germany.
Oliver
O
Deutsch
Klinik für Anästhesiologie, Technische Universität München, Germany.
Bettina
B
Jungwirth
Klinik für Herz-, Thorax- und Gefäßchirurgie, Herz- und Diabeteszentrum Karlsburg, Germany.
Elpiniki
E
Katsari
Klinik für Herzchirurgie, Herzzentrum Leipzig, Universität Leipzig, Frankfurt/M., Germany.
Pascal
P
Dohmen
Klinik für Herzchirurgie, Herzzentrum Leipzig, Universität Leipzig, Frankfurt/M., Germany.
Bettina
B
Pfannmueller
Center for Gender Medicine, Karolinska Institute, Stockholm, Sweden, Germany.
Rebecka
R
Hultgren
Klinik und Poliklinik für Thorax-, Herz- und Thorakale Gefäßchirurgie, Universitätsklinikum Würzburg, Germany.
Ina
I
Schade
Center for Gender Medicine, Karolinska Institute, Stockholm, Sweden, Germany.
Karolina
K
Kublickiene
Klinik für Herzchirurgie, Herzzentrum Leipzig, Universität Leipzig, Frankfurt/M., Germany.
Friedrich W
FW
Mohr
Klinik für Herzchirurgie, Klinikum Bogenhausen, Städtisches Klinikum München, Germany.
Brigitte
B
Gansera
Cardiac surgery; Gender; Outcome; Risk factors