Female Gender is not a Risk Factor for Early Mortality after Coronary Artery Bypass Grafting

Abstract

Background: The female gender is considered as a risk factor for morbidity and mortality after coronary artery bypass grafting (CABG). Aim: In this analysis, we assessed the impact of female gender on early outcome after CABG. Study Design: This is a retrospective analysis of data from our center situated in South India. Statistical Analysis: 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. Methods: 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. Results: 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. Conclusions: Early mortality in females was similar to that of males. Females were associated with higher rate of wound infection and readmission to hospital.

Risk Factors Associated with an Increased Risk of Deep Sternal Wound Infections in Patients After Coronary Artery Bypass Grafting and Heart Defect Surgery

“…Postoperative blood transfusion increases the risk to develop an infection after cardiac surgery as well as morbidity and mortality. This also was found in other research [Brunet 2020;Diez 2007;LaPar 2018;Lemaignen 2015;Oprea 2018;Risnes 2010;Schimmer 2016;Varma 2019].…”

“…Diabetes mellitus, female gender, older age, and renal failure have been identified as risk factors for postoperative DSWI in previous studies [Ahmed 2011;Badawy 2014;Gatti 2015;Heilmann 2013;Kubota 2013;Lemaignen 2015;Ohira 2019;Risnes 2010;Sá 2011;Varma 2019]. Nevertheless, we have not observed any significant associations between diabetes mellitus, female gender, older age, renal failure, and a higher incidence of DSWI.…”

“…Our data also show that the risk for mediastinitis increases by 1.15 times per additional kilogram body mass per square meter body surface. Numerous studies also have identified obesity as one of the strongest risk factors for postoperative DSWI [Ahmed 2011;Badawy 2014;Diez 2007, Gatti 2015Lemaignen 2015;Meszaros 2016;Oliveira 2017;Risnes 2010;Sá 2017;Sá 2011;Schimmer 2016;Varma 2019;Vos 2018]. There are some factors that could explain why obesity is associated with the postoperative DSWI, and these factors have been discussed in previous studies.…”

“…Coronary artery bypass grafting (CABG) is an effective treatment option for coronary artery disease [Varma 2019]. Valvular heart diseases successfully are treated surgically as well [Taylor 2012].…”

Patient and hospital factors associated with 30-day readmissions after coronary artery bypass graft (CABG) surgery: a systematic review and meta-analysis

“…Forty studies [ 7 , 8 , 11 – 14 , 20 – 26 , 28 – 37 , 39 – 44 , 46 – 49 , 52 , 54 , 58 , 59 , 62 , 64 , 65 ] (75% of all included studies) were from the USA. Most studies [ 7 , 8 , 11 – 14 , 20 , 21 , 25 , 27 , 32 , 33 , 35 – 37 , 39 – 42 , 44 , 46 – 49 , 52 , 58 , 59 , 61 , 63 , 65 , 66 ] ( n = 31) were based on administrative data aggregated across multiple sites and 22 studies [ 22 – 24 , 26 , 28 – 31 , 34 , 38 , 43 , 45 , 50 , 51 , 53 – 57 , 60 , 62 , 64 ] used medical records from either a single center or multiple centers. The included studies varied widely in sample size (range: 110 to 1,116,991).…”