Ritchison Andrew, Smith J Michael, Engel Amy M
Department of Surgery, Good Samaritan Hospital, Los Angeles, California, USA.
J Card Surg. 2007 Sep-Oct;22(5):401-5. doi: 10.1111/j.1540-8191.2007.00434.x.
The objective was to examine the influence of gender in diabetic patients following coronary artery bypass graft (CABG) surgery.
A study from an 11-year hospitalization cohort with prospective data collection was conducted. Included in the study were diabetic patients undergoing CABG surgery between October 1993 and May 2004 (n = 2781). Patients who underwent any surgery other than CABG or had a previous cardiac surgery were excluded. The study examined 25 risk factors and 14 outcome variables.
Twelve risk factors were found to be significantly different between male and female diabetic patients undergoing CABG. Correlation coefficients were computed among the 12 significant risk factors. Three main risk factors emerged: age 70 years or greater, abnormal LVH, and number of grafts. For outcome variables, females experienced more renal complications, intraoperative complications, longer hospital stay, and mortality. Logistic regression analysis showed that after controlling for age, LVH, and number of grafts, female diabetic patients undergoing CABG were more likely to experience intraoperative complications (OR 1.8, 95% CI 1.1-3.0, p = 0.025) and longer hospital stay (OR 0.99, 95% CI 0.97-0.99, p = 0.039). However, there was no significant difference between male and female diabetic patients after CABG surgery with renal complications (OR 1.39, 95% CI 0.95-2.1, p = 0.132) or mortality (OR 1.6, 95% CI 0.85-2.8, p = 0.153).
Female diabetic patients, when compared to male diabetic patients undergoing CABG, have significantly more intraoperative complications and longer hospital stays following surgery.
本研究旨在探讨性别对冠状动脉旁路移植术(CABG)后糖尿病患者的影响。
开展一项基于11年住院队列的前瞻性数据收集研究。研究纳入了1993年10月至2004年5月期间接受CABG手术的糖尿病患者(n = 2781)。排除接受过CABG以外的其他手术或既往有心脏手术史的患者。本研究检测了25项风险因素和14项结局变量。
发现12项风险因素在接受CABG的男性和女性糖尿病患者之间存在显著差异。计算了这12项显著风险因素之间的相关系数。出现了三个主要风险因素:年龄70岁及以上、左心室肥厚异常和移植血管数量。对于结局变量,女性出现更多的肾脏并发症、术中并发症、住院时间更长且死亡率更高。逻辑回归分析显示,在控制年龄、左心室肥厚和移植血管数量后,接受CABG的女性糖尿病患者更易出现术中并发症(比值比1.8,95%置信区间1.1 - 3.0,p = 0.025)和住院时间更长(比值比0.99,95%置信区间0.97 - 0.99,p = 0.039)。然而,CABG术后男性和女性糖尿病患者在肾脏并发症(比值比1.39,95%置信区间0.95 - 2.1,p = 0.132)或死亡率(比值比1.6,95%置信区间0.85 - 2.8,p = 0.153)方面无显著差异。
与接受CABG的男性糖尿病患者相比,女性糖尿病患者术后术中并发症显著更多,住院时间更长。