Impact of sex on outcomes after cardiac surgery: A systematic review and meta-analysis

Dixon, Lauren; Tommaso, Ettorino Di; Dimagli, Arnaldo; Sinha, Shubhra; Sandhu, Manraj; Benedetto, Umberto; Angelini, Gianni D

doi:10.1016/j.ijcard.2021.09.011

Cited by 36 publications

(25 citation statements)

References 62 publications

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“…An interesting finding in our study was that the probability of dying in hospital was higher for COPD women who underwent CABG or OVRP. In the same way, Dixon et al [34] conducted a systematic review and meta-analysis and concluded that females are at a greater risk of short-term mortality and post-operative stroke than males following CABG and valve surgery combined with CABG. Our findings add to the existing published literature on gender disparities after cardiac surgery by providing a description of IHM after cardiac procedures in COPD patients.…”

Section: Discussionmentioning

confidence: 99%

“…Fifth, our database does not include information on the reason why a surgery was not conducted (patient refusal or postponement or cancellation by health services). However, studies conducted in Spain have concluded that most surgeries were postponed or cancelled by health authorities due to hospitals and intensive care units being overloaded with COVID-19 infected patients [34][35][36]. Finally, the codes to identify the study outcomes were inferred from ICD-10, so the existence of misclassification bias cannot be discarded.…”

Section: Limitationsmentioning

confidence: 99%

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Impact of the COVID-19 Pandemic on the Use and Outcomes of Cardiac Procedures in COPD Patients

Miguel-Díez

Jiménez-García

Miguel‐Yanes

et al. 2022

JCM

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(1) Background: The aim of this study was to assess the effects of the COVID-19 pandemic on the use and outcomes of cardiac procedures among people with chronic obstructive pulmonary disease (COPD) in Spain. (2) Methods: We used national hospital discharge data to select patients admitted to hospital with a diagnosis of COPD from 1 January 2019 to 31 December 2020. (3) Results: The number of COPD patients hospitalized in 2019 who underwent a cardiac procedure was 4483, 16.2% higher than in 2020 (n = 3757). The length of hospital stay was significantly lower in 2020 than in 2019 (9.37 vs. 10.13 days; p = 0.004), and crude in-hospital mortality (IHM) was significantly higher (5.32% vs. 4.33%; p = 0.035). Multivariable logistic regression models to assess the differences in IHM from 2019 to 2020 showed Odds Ratio (OR) values over 1, suggesting a higher risk of dying in 2020 compared to in 2019. However, the ORs were only statistically significant for “any cardiac procedure” (1.18, 95% CI 1.03–1.47). The Charlson comorbidity index increased IHM for each of the procedures analyzed. The probability of IHM was higher for women and older patients who underwent coronary artery bypass graft or open valve replacement procedures. Suffering a COVID-19 infection was associated with significantly higher mortality after cardiac procedures. (4) Conclusions: The COVID-19 pandemic limited the access to healthcare for patients with COPD.

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Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on the Use and Outcomes of Cardiac Procedures in COPD Patients

Miguel-Díez

Jiménez-García

Miguel‐Yanes

et al. 2022

JCM

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“…However, this does mean that currently, the results are only applicable to men undergoing CABG. Women are at a higher risk of short-term mortality after cardiac surgery [29,30]. It is unclear how much of this difference is physiological and how much is organizational.…”

Section: Discussionmentioning

confidence: 99%

Modelling the dynamic interaction of systemic inflammation and the hypothalamic–pituitary–adrenal (HPA) axis during and after cardiac surgery

Galvis

Zavala

Walker

et al. 2022

J. R. Soc. Interface.

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Major surgery and critical illness produce a potentially life-threatening systemic inflammatory response. The hypothalamic–pituitary–adrenal (HPA) axis is one of the key physiological systems that counterbalances this systemic inflammation through changes in adrenocorticotrophic hormone (ACTH) and cortisol. These hormones normally exhibit highly correlated ultradian pulsatility with an amplitude modulated by circadian processes. However, these dynamics are disrupted by major surgery and critical illness. In this work, we characterize the inflammatory, ACTH and cortisol responses of patients undergoing cardiac surgery and show that the HPA axis response can be classified into one of three phenotypes: single-pulse, two-pulse and multiple-pulse dynamics. We develop a mathematical model of cortisol secretion and metabolism that predicts the physiological mechanisms responsible for these different phenotypes. We show that the effects of inflammatory mediators are important only in the single-pulse pattern in which normal pulsatility is lost—suggesting that this phenotype could be indicative of the greatest inflammatory response. Investigating whether and how these phenotypes are correlated with clinical outcomes will be critical to patient prognosis and designing interventions to improve recovery.

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“…To be reliable, the application of such models should be demonstrated on varied validation data sets in the same setting. Furthermore, the imbalance of the male to female ratio (75% to 25%) of the sample population affects the generalization and applicability of the results, as the female sex is a known risk factor in cardiac surgery, mainly coronary and valve surgery 8 . Although these criticisms are within reason, the population used was homogenous, supporting the validation of the data set.…”

mentioning

confidence: 91%

The catastrophe of hypoxia in complex aortic surgery

Kayal

Rajasekar

Harky

2022

Journal of Cardiac Surgery

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Impact of sex on outcomes after cardiac surgery: A systematic review and meta-analysis

Cited by 36 publications

References 62 publications

Impact of the COVID-19 Pandemic on the Use and Outcomes of Cardiac Procedures in COPD Patients

Impact of the COVID-19 Pandemic on the Use and Outcomes of Cardiac Procedures in COPD Patients

Modelling the dynamic interaction of systemic inflammation and the hypothalamic–pituitary–adrenal (HPA) axis during and after cardiac surgery

The catastrophe of hypoxia in complex aortic surgery

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