Khan Jamal Kabeer, Shahabuddin Syed, Khan Sheema, Bano Gulshan, Hashmi Shiraz, Sami Shahid A
The Aga Khan University Hospital, Karachi, Pakistan.
Ann Med Surg (Lond). 2016 Jun 2;9:33-7. doi: 10.1016/j.amsu.2016.05.018. eCollection 2016 Aug.
Outcomes following Coronary artery bypass grafting (GABG) vary between genders, with females having a higher postoperative mortality than males. Most of the studies are on Caucasian or mixed population and it is postulated that Asian population and in particular women have higher morbidity and mortality. In this study we have compared outcomes of elective CABG in men and women of South Asian origin in terms of morbidity and mortality.
From January 2006 to December 2012, 1970 patients underwent isolated elective CABG at the Aga Khan University Hospital, Pakistan were selected. The prospectively collected data was analyzed retrospectively including univariate and multivariate analysis to find the association of morbidity and mortality.
Among the study patients 1664 (85%) were male and 306 (15%) female. Hypertension and diabetes were the most common comorbid conditions seen preoperatively in female patients. Atrial fibrillation and sepsis were the most common postop complications seen in females. In hospital mortality was 3.9% in female underwent CABG as against 0.6% in male. Multivariate analysis showed older age, renal failure, dyslipidemia and prolonged cross clamp time as predictors of postoperative morbidity. Multivariate analysis showed female gender, age and renal failure as predictors of in hospital mortality.
Female gender is an independent risk factor for postoperative mortality following CABG however, female gender is not found to be independent risk factor for morbidity. The trend of higher mortality in female patients was comparable to most studies done on Caucasian patients.
冠状动脉旁路移植术(CABG)后的结果因性别而异,女性术后死亡率高于男性。大多数研究针对的是白种人或混合人群,据推测亚洲人群尤其是女性的发病率和死亡率更高。在本研究中,我们比较了南亚裔男性和女性择期CABG在发病率和死亡率方面的结果。
选取2006年1月至2012年12月在巴基斯坦阿迦汗大学医院接受单纯择期CABG的1970例患者。对前瞻性收集的数据进行回顾性分析,包括单因素和多因素分析,以找出发病率和死亡率的关联。
在研究患者中,1664例(85%)为男性,306例(15%)为女性。高血压和糖尿病是女性患者术前最常见的合并症。房颤和败血症是女性术后最常见的并发症。接受CABG的女性患者院内死亡率为3.9%,而男性为0.6%。多因素分析显示,年龄较大、肾衰竭、血脂异常和体外循环时间延长是术后发病的预测因素。多因素分析显示,女性、年龄和肾衰竭是院内死亡的预测因素。
女性是CABG术后死亡的独立危险因素,然而,未发现女性是发病的独立危险因素。女性患者较高死亡率的趋势与大多数针对白种人患者的研究相当。