Gardarsdottir Helga Run, Arnadottir Linda Osk, Adalsteinsson Jonas A, Johannesdottir Hera, Helgadottir Solveig, Hrafnkelsdottir Thordis Jona, Geirsson Arnar, Gudbjartsson Tomas
Departments of Cardiothoracic Surgery and Cardiology, Landspitali University Hospital, Iceland.
Departments of Cardiothoracic Surgery.
Laeknabladid. 2018;104(7):335-340. doi: 10.17992/lbl.2018.0708.192.
Introduction The aim of this study was to evaluate the outcome of coronary artery bypass grafting (CABG) in women compared to men, with focus on short-term and long-term complications, 30 day mortality and survival. Materials and methods This was a retrospective study on all CABG patients operated in Iceland between 2001 and 2013. Clinical information was gathered from hospital charts and survival data was obtained from the National Statistics in Iceland. Overall survival was estimated with the Kaplan- Meier method. Logistic and Cox regression analysis were used to identify predictors of operative mortality and long-term survival. Mean follow-up was 6.8 years. Results Of 1755 patients 318 were women (18%). Women were on average four years older than men at the time of operation (69 vs. 65 yrs, p<0.001). Female patients had a higher incidence of hypertension (72 vs. 64%, p=0.009) and their EuroSCOREst was higher (6.1 vs. 4.3, p<0.001). The prevalence of diabetes, dyslipidemia and the extent of coronary artery disease was comparable between groups. The rate of short-term complications, both minor (53% vs. 48%, p=0.07) and major (27% vs. 32%, p=0.2), was similar and operative mortality for women was not statistically different from males (4% vs. 2%, p=0.08). Female gender was neither found to be a predictor of 30-day mortality (OR 0.99; 95%-CI: 0.98-1.01) nor survival (HR 1,08; 95%-ÖB: 0,82-1,42). Conclusions The number of women that undergo CABG is low and they are four years older than men when operated on. As is the case with men, outcome following CABG in Iceland is very good for women, their overall five-year survival being 87%.
引言 本研究的目的是评估女性与男性冠状动脉旁路移植术(CABG)的结果,重点关注短期和长期并发症、30天死亡率和生存率。材料与方法 这是一项对2001年至2013年在冰岛接受CABG手术的所有患者的回顾性研究。临床信息从医院病历中收集,生存数据从冰岛国家统计局获得。采用Kaplan-Meier方法估计总体生存率。使用逻辑回归和Cox回归分析来确定手术死亡率和长期生存的预测因素。平均随访时间为6.8年。结果 在1755例患者中,318例为女性(18%)。女性手术时平均比男性大4岁(69岁对65岁,p<0.001)。女性患者高血压发病率较高(72%对64%,p=0.009),其欧洲心脏手术风险评估系统(EuroSCORE)评分更高(6.1对4.3,p<0.001)。两组之间糖尿病、血脂异常的患病率和冠状动脉疾病的程度相当。短期并发症发生率,无论是轻微并发症(53%对48%,p=0.07)还是严重并发症(27%对32%,p=0.2),都相似,女性的手术死亡率与男性无统计学差异(4%对2%,p=0.08)。未发现女性性别是30天死亡率(比值比0.99;95%置信区间:0.98-1.01)或生存率(风险比1.08;95%置信区间:0.82-1.42)的预测因素。结论 接受CABG手术的女性数量较少,手术时她们比男性大4岁。与男性一样,冰岛女性CABG术后的结果非常好,其总体五年生存率为87%。