Sex differences in health status after coronary artery bypass surgery

Abstract

Background-Although previous studies have shown functional improvements in patients who undergo coronary artery bypass graft (CABG) surgery, data are conflicting on whether the gains achieved by women are similar to or less than those achieved by men. Methods and Results-We compared physical and psychological functional gains and readmission rates between 777 men and 295 women who underwent first CABG consecutively between February 1999 and February 2001. Physical function and mental health were measured by means of the Short Form 36-Item Health Survey (SF-36). At 6 months, both men and women showed, on average, a significant improvement in physical function and mental health, but men improved significantly more than women. After adjustment for baseline characteristics, the mean score improvement in women was half that of men for physical function (7.3 versus 14.0, Pϭ0.0002) and 25% less than that of men for mental health (Ϫ3.0 versus 8.9, Pϭ0.026). The absolute rates of adverse outcomes, such as hospital readmission, worsening functional status, and worsening mental health, were significantly higher in women (32.6%, 25.7%, and 17.5%, respectively) than in men (21.2%, 11.1%, and 12.6%, respectively) and remained significantly different in multivariable analysis. Conclusions-CABG surgery is associated with lower functional gains and higher readmission rates in women compared with men 6 months after operation.

Impaired health status in Type D patients following PCI in the drug-eluting stent era

“…The reason for the lack of association between Type D and physical functioning may be that for this sub domain, baseline health status had a considerably larger impact (26-fold) than for any of the other sub domains (ranging from 5-to 9-fold). Improvement in health status over time following revascularization is consistent with other studies post-CABG [10] and PCI [28] indicating the beneficial effects of revascularization on health status. However, in the current study we showed that subgroups of patients may not benefit from PCI on par with other patients, as Type D patients experienced significantly impaired health status compared with non-Type D patients.…”

“…Prior history of depression [8] and smoking [9] also have been shown to impede the benefits of PCI on health status. Other factors associated with impaired health status include female gender [10,11], impaired left ventricular function [12], depression [13], and the distressed (Type D) personality [14], although the majority of these studies were conducted in patients with acute coronary syndromes rather than in patients following PCI.…”

Development of the Korean Version of Short-Form 36-Item Health Survey: Health Related QOL of Healthy Elderly People and Elderly Patients in Korea

“…Some pre-studies showed differences in pain experience between females and males (Fillingim and Maixner 1995;Berkley 1997). Other studies using SF-36 also reported the sex-differences (lower scores in females) (Gift and Shepard 1999;O'Dea et al 1999;Vaccarino et al 2003).…”

Depression and cardiovascular disease

“…Second, the relationship was more pronounced in women than it was in men. This may explain why women may derive less functional benefit from CABG surgery 5 and suggests the particular importance of considering depression as a cofactor among women undergoing cardiac surgery. Third, the focus on health status outcomes is to be commended.…”