Goncharov Maxim, Silva Erlon Oliveira de Abreu, Silva Pedro Gabriel Melo de Barros E, Freitas Fabiane Letícia de, Moreira Adriana Costa, Tramujas Lucas, Cavalcanti Alexandre Biasi, Liguori Ieda Maria, Jatene Fabio Biscegli, Jatene Ieda Biscegli, Alves Claudia Maria Rodrigues
Hospital do Coração, São Paulo, SP - Brasil.
Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.
Arq Bras Cardiol. 2025 Apr;122(5):e20240664. doi: 10.36660/abc.20240664.
Women undergoing coronary artery bypass grafting (CABG) tend to have worse in-hospital outcomes, but it is unclear whether these differences are due to gender or to clinical factors.
To compare in-hospital outcomes between women and men undergoing CABG.
This was a single-center, retrospective observational study analyzing data from 9,845 patients who underwent CABG between 1995 and 2022, of whom 1,947 (19.8%) were women. To evaluate female gender as a prognostic factor for in-hospital mortality, we used descriptive statistics, univariate and multivariate logistic regression, and propensity score matching. The significance level was set at 5%.
Women were older (66.7 vs 62.19 years, p<0.001), had lower body mass index (26.91 vs 27.64, p<0.001), and had a higher prevalence of diabetes mellitus (34.0% vs 31.6%, p=0.045). They also had longer hospital stays (14.84 vs 13.13 days, p<0.001) and higher operative mortality (4.8% vs 2.4%, p<0.001). In logistic regression, female gender was associated with higher mortality (OR=1.51; 95% CI: 1.15-1.99; p=0.003). After matching, there was no significant difference in mortality (OR=1.20; 95% CI: 0.88-1.64; p=0.241), but length of hospital stay remained longer in women.
When clinical factors were matched between men and women, the mortality difference disappeared. This suggests that targeted interventions to reduce disparities may help improve mortality outcomes in women undergoing CABG.
接受冠状动脉旁路移植术（CABG）的女性往往院内结局更差，但尚不清楚这些差异是由于性别还是临床因素所致。
比较接受CABG的女性和男性的院内结局。
这是一项单中心回顾性观察研究，分析了1995年至2022年间9845例接受CABG患者的数据，其中1947例（19.8%）为女性。为了评估女性性别作为院内死亡的预后因素，我们使用了描述性统计、单因素和多因素逻辑回归以及倾向评分匹配。显著性水平设定为5%。
女性年龄更大（66.7岁对62.19岁，p<0.001），体重指数更低（26.91对27.64，p<0.001），糖尿病患病率更高（34.0%对31.6%，p=0.045）。她们的住院时间也更长（14.84天对13.13天，p<0.001），手术死亡率更高（4.8%对2.4%，p<0.001）。在逻辑回归中，女性性别与更高的死亡率相关（比值比=1.51；95%置信区间：1.15-1.99；p=0.003）。匹配后，死亡率无显著差异（比值比=1.20；95%置信区间：0.88-1.64；p=0.241），但女性的住院时间仍然更长。
当男性和女性的临床因素相匹配时，死亡率差异消失。这表明针对性的干预措施以减少差异可能有助于改善接受CABG的女性的死亡结局。
