Gurram Akhil, Krishna Neethu, Vasudevan Anu, Baquero Luis Alberto, Jayant Aveek, Varma Praveen Kerala
Divisions of Cardio-Thoracic Surgery, Amrita Institute of Medical Sciences and Research Center, Amrita Viswa Vidyapeetham (Amrita University), Kochi, Kerala, India.
Biostatistics, Amrita Institute of Medical Sciences and Research Center, Amrita Viswa Vidyapeetham (Amrita University), Kochi, Kerala, India.
Ann Card Anaesth. 2019 Apr-Jun;22(2):187-193. doi: 10.4103/aca.ACA_27_18.
The female gender is considered as a risk factor for morbidity and mortality after coronary artery bypass grafting (CABG).
In this analysis, we assessed the impact of female gender on early outcome after CABG.
This is a retrospective analysis of data from our center situated in South India.
Patients were categorized according to gender and potential differences in pre-operative and post-operative factors were explored. Significant risk factors were then built in a multivariate model to account for differences in predicting gender influence on surgical outcome.
773 consecutive patients underwent first time CABG between January 2015 and December 2016. 96.77% of cases were performed using off-pump technique. 132 (17.07%) patients were females. These patients formed the study group.
The in-house/ 30-day mortality in females was similar to that of males (3.03% vs. 3.12%, p value 0.957). Mediastinitis developed more commonly in females (5.35% vs. 1.30%; p value 0.004) compared to males. There were more re-admissions to hospital for female patients (21.37% in females vs. 10.14% in males, p value <0.001). In multivariate analysis using logistic regression; there was a significant association between age (OR 1.08), chronic obstructive airway disease (OR 4.315), and use of therapeutic antibiotics (OR 6.299), IABP usage (OR 11.18) and renal failure requiring dialysis (OR 28.939) with mortality.
Early mortality in females was similar to that of males. Females were associated with higher rate of wound infection and readmission to hospital.
女性被认为是冠状动脉旁路移植术（CABG）后发病和死亡的危险因素。
在本分析中，我们评估了女性性别对CABG术后早期结局的影响。
这是一项对位于印度南部我们中心的数据进行的回顾性分析。
根据性别对患者进行分类，并探讨术前和术后因素的潜在差异。然后将显著的危险因素纳入多变量模型，以解释预测性别对手术结局影响方面的差异。
2015年1月至2016年12月期间，773例连续患者接受了首次CABG。96.77%的病例采用非体外循环技术进行。132例（17.07%）患者为女性。这些患者组成了研究组。
女性患者的院内/30天死亡率与男性相似（3.03%对3.12%，p值0.957）。与男性相比，女性发生纵隔炎更为常见（5.35%对1.30%；p值0.004）。女性患者再次入院的情况更多（女性为21.37%，男性为10.14%，p值<0.001）。在使用逻辑回归的多变量分析中；年龄（OR 1.08）、慢性阻塞性气道疾病（OR 4.315）、使用治疗性抗生素（OR 6.299）、使用主动脉内球囊反搏（IABP）（OR 11.18）和需要透析的肾衰竭（OR 28.939）与死亡率之间存在显著关联。
女性的早期死亡率与男性相似。女性与更高的伤口感染率和再次入院率相关。
