Gong Lu-Jia, Lehmkuhl Elke, Hu Sheng-shou, Kendel Friederike, Kandle Stein, Du Yong, Zhang Yan, Du Ming, Wu Qing-yu, Xu Jian-ping, Sun Li-zhong, Zhu Xiao-dong, Regitz-Zagrosek Vera
Department of Surgery, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2006 May;34(5):415-21.
The purpose of this study was to explore the association of gender and age on in-hospital mortality after coronary artery bypass graft (CABG) among the Chinese population.
A total of 2682 patients (male: 2316, female: 366) who underwent CABG surgery were retrospectively investigated between January 1st, 1997 and December 31st, 2001 for perioperative risk factors and in-hospital mortality rate after CABG.
Preoperative comorbidity rate and postoperative complication rate were higher in women than that in men, although left ventricular ejection fraction was higher and the number of diseased vessels fewer in women than in men. The in-hospital mortality rate was three times higher in women than that in men (3.01% vs. 1.12%, P = 0.001), especially in the younger age group (2.6% vs. 0.5%, P = 0.001, risk-adjusted odds ratio 4.844, 95% CI: 1.549 - 15.142). In older patients, there was no notable difference in in-hospital mortality between the genders (3.7% for women vs. 2.4% for men, P = 0.383).
Chinese woman, especially in younger age, had a higher in-hospital mortality rate post CABG than that in men, suggesting that younger female gender is an independent risk factor for in-hospital mortality after CABG. Future studies are warranted to clarify the underlying mechanisms.
本研究旨在探讨中国人群中性别和年龄与冠状动脉旁路移植术（CABG）后院内死亡率之间的关联。
回顾性调查了1997年1月1日至2001年12月31日期间接受CABG手术的2682例患者（男性：2316例，女性：366例）的围手术期危险因素及CABG后的院内死亡率。
女性术前合并症发生率和术后并发症发生率高于男性，尽管女性左心室射血分数较高且病变血管数量少于男性。女性院内死亡率是男性的三倍（3.01%对1.12%，P = 0.001），尤其是在年轻年龄组（2.6%对0.5%，P = 0.001，风险调整优势比4.844，95%CI：1.549 - 15.142）。在老年患者中，性别间院内死亡率无显著差异（女性为3.7%，男性为2.4%，P = 0.383）。
中国女性，尤其是年轻女性，CABG术后院内死亡率高于男性，提示年轻女性是CABG术后院内死亡的独立危险因素。有必要开展进一步研究以阐明潜在机制。
