Bestawros A, Filion Kristian B, Haider Seema, Pilote Louise, Eisenberg Mark J
Montreal General Hospital/McGill University, Montreal, Canada.
Can J Cardiol. 2005 Nov;21(13):1195-200.
Coronary artery bypass graft surgery (CABG) in women has been associated with worse clinical outcomes than CABG in men. However, little is known about the impact of sex on the cost of CABG.
To examine the impact of sex on hospital course and the cost of CABG.
Hospital course and cost were examined among 2880 female and 9137 male patients from four Canadian and five American hospitals. Data were obtained from a resource and cost accounting system used by each of the nine hospitals.
Among the 12,017 patients who underwent CABG, 24% (n=2880) were women and 76% (n=9137) were men. Women had a significantly longer length of stay (LOS) than did men (10.3+/-0.2 days and 8.9+/-0.08 days, respectively; P<0.0001) and a significantly higher in-hospital mortality than did men (2.6% and 1.5%, respectively; P<0.0001). The total unadjusted cost was higher for women than for men both in Canada (US$11,200+/-268 and US$10,143+/-139, respectively; P<0.0001) and the United States (US$22,715+/-509 and US$19,906+/-269, respectively; P<0.0001). After adjusting for age and comorbid conditions, female sex was associated with a 10% increase in LOS (P<0.0001), a 97% increase in mortality (P=0.0006) and a 7% increase in overall cost (P<0.0001).
Compared with men, women undergoing CABG had a modestly increased LOS and a higher mortality. Total in-hospital cost was higher for women in each of the nine hospitals studied. Compared with other clinical variables, female sex is a relatively minor determinant of cost. Nevertheless, because of the expected increase in the number of women undergoing CABG in the future, this increased cost may translate into an important economic burden.
与男性冠状动脉旁路移植术（CABG）相比，女性接受该手术的临床结局更差。然而，关于性别对CABG成本的影响却知之甚少。
研究性别对CABG住院过程及成本的影响。
对来自加拿大4家医院和美国5家医院的2880例女性患者和9137例男性患者的住院过程及成本进行研究。数据来自这9家医院各自使用的资源和成本核算系统。
在12017例行CABG的患者中，24%（n = 2880）为女性，76%（n = 9137）为男性。女性的住院时间显著长于男性（分别为10.3±0.2天和8.9±0.08天；P<0.0001），住院死亡率也显著高于男性（分别为2.6%和1.5%；P<0.0001）。在加拿大，女性的总未调整成本高于男性（分别为11200美元±268美元和10143美元±139美元；P<0.0001），在美国也是如此（分别为22715美元±509美元和19906美元±269美元；P<0.0001）。在对年龄和合并症进行调整后，女性性别与住院时间增加10%相关（P<0.0001），死亡率增加97%（P = 0.0006），总成本增加7%（P<0.0001）。
与男性相比，接受CABG的女性住院时间适度延长，死亡率更高。在所研究的9家医院中，女性的住院总成本均更高。与其他临床变量相比，女性性别是成本的一个相对较小的决定因素。然而，由于未来接受CABG的女性数量预计会增加，这种成本增加可能会转化为一项重要的经济负担。
