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老年女性冠状动脉旁路移植手术的术后早期结果与男性相比更差吗?

Are the Early Postoperative Outcomes of Coronary Artery Bypass Grafting Surgery in Elderly Women Worse Compared to Men's?

作者信息

Yüksel Ahmet, Kan Irem Iris, Yolgösteren Atıf, Velioğlu Yusuf, Çayır Mustafa Çagdaş, Gürbüz Orçun, Kumtepe Gencehan, Akarsu Serkan, Biçer Murat, Tok Mustafa, Şenkaya Işık

机构信息

Department of Cardiovascular Surgery of Bursa State Hospital, Bursa, Turkey.

Department of Cardiovascular Surgery of Uludag University Faculty of Medicine, Bursa, Turkey.

出版信息

Braz J Cardiovasc Surg. 2017 May-Jun;32(3):191-196. doi: 10.21470/1678-9741-2016-0071.

Abstract

OBJECTIVE

: To investigate the impact of gender difference in early postoperative outcomes in elderly patients (aged 70 or older) undergoing coronary artery bypass grafting surgery.

METHODS

: Between October 2009 and December 2013, a total of 223 elderly patients (aged 70 or older) undergoing isolated primary coronary artery bypass grafting surgery were included in this retrospective observational cohort study. Patients were divided into two groups according to their gender. The patients' medical records were collected, their baseline preoperative characteristics, operative data, and postoperative outcomes were retrospectively reviewed, and the effect of gender difference in the early postoperative outcomes was analyzed.

RESULTS

: Group 1 (female patients) and Group 2 (male patients) consisted of 71 and 152 patients, respectively. Mean age of patients was 74.4±3.6 years (range: 70-84 years). The level of EuroSCORE I, the incidence of hypertension and hyperlipidemia were significantly higher in Group 1, while the rate of smoking was significantly higher in Group 2. Mean postoperative intubation time, length of intensive care unit and hospital stay were longer in female patients than in male patients, but these differences were not statistically significant. No statistically significant difference between two groups in terms of the transfusion of blood products was observed. The rates of in-hospital mortality and major postoperative complications were statistically similar between the two groups.

CONCLUSION

: In conclusion, the female gender was not associated with worse early postoperative outcomes in elderly patients undergoing coronary artery bypass grafting surgery.

摘要

目的

探讨年龄在70岁及以上的老年患者行冠状动脉搭桥手术时性别差异对术后早期结局的影响。

方法

在2009年10月至2013年12月期间,本回顾性观察队列研究纳入了总共223例年龄在70岁及以上、接受单纯初次冠状动脉搭桥手术的老年患者。根据性别将患者分为两组。收集患者的病历,回顾性分析其术前基线特征、手术数据及术后结局,分析性别差异对术后早期结局的影响。

结果

第1组(女性患者)和第2组(男性患者)分别有71例和152例患者。患者的平均年龄为74.4±3.6岁(范围:70 - 84岁)。第1组的欧洲心脏手术风险评估系统I(EuroSCORE I)水平、高血压和高脂血症的发生率显著更高,而第2组的吸烟率显著更高。女性患者术后平均插管时间、重症监护病房住院时间和住院时间均长于男性患者,但这些差异无统计学意义。两组在血液制品输注方面未观察到统计学显著差异。两组的院内死亡率和主要术后并发症发生率在统计学上相似。

结论

总之,在接受冠状动脉搭桥手术的老年患者中,女性性别与术后早期结局较差无关。

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