Abbas Mostafa, Morland Thomas, Sharma Rohit, Shuhaiber Jeffrey, Kirchner H Lester, El-Manzalawy Yasser
Department of Population Health Sciences, Geisinger, Danville, PA, USA.
Department of General Internal Medicine, Geisinger, Danville, PA, USA.
Heliyon. 2025 Jan 4;11(2):e41723. doi: 10.1016/j.heliyon.2025.e41723. eCollection 2025 Jan 30.
Females undergoing coronary artery bypass grafting (CABG) surgery have been reported to be at increased risk of postoperative mortality and comorbidity. Our main objective is to evaluate the impact of female sex on 30-day mortality after isolated CABG surgery.
We created a retrospective cohort of adult patients underwent isolated CABG surgery between 2006 and 2020 in a large rural healthcare system. Patients were grouped by sex and a 1:1 nearest neighbor propensity score matching method was performed to reduce the bias due to potential confounding. Association between female sex and 30-day mortality was assessed using conditional regression analysis and appropriate statistical tests for matched analyses. Associations between female sex and eight secondary outcomes were also considered.
Out of 5616 adult patients underwent isolated CABG surgery, 1352 were females. The propensity scoring matching method provided 1346 matched pairs with no observed significant imbalance for any of the included confounders. The conditional logistic regression analysis showed independent association between female sex and 30-day mortality (OR = 1.83, CI = 1.10-3.04, p = 0.02).
Females undergoing isolated CABG surgery were at significantly greater risk of postoperative 30-day mortality and longer postoperative length of stay. Further research is needed to identify and address the causes of these disparities.
据报道，接受冠状动脉旁路移植术（CABG）的女性术后死亡和合并症风险增加。我们的主要目标是评估性别对单纯CABG术后30天死亡率的影响。
我们建立了一个回顾性队列，纳入了2006年至2020年在一个大型农村医疗系统中接受单纯CABG手术的成年患者。按性别对患者进行分组，并采用1:1最近邻倾向评分匹配方法以减少潜在混杂因素导致的偏差。使用条件回归分析和适用于匹配分析的适当统计检验评估女性与30天死亡率之间的关联。还考虑了女性与八个次要结局之间的关联。
在5616例接受单纯CABG手术的成年患者中，有1352例为女性。倾向评分匹配方法提供了1346对匹配病例，所纳入的任何混杂因素均未观察到明显失衡。条件逻辑回归分析显示女性与30天死亡率之间存在独立关联（OR = 1.83，CI = 1.10 - 3.04，p = 0.02）。
接受单纯CABG手术的女性术后30天死亡率显著更高，术后住院时间更长。需要进一步研究以确定并解决这些差异的原因。
