Cardiac and Neurologic Complications Identify Risks for Mortality for Both Men and Women Undergoing Coronary Artery Bypass Graft Surgery
Cardiac and Neurologic Complications Identify Risks for Mortality for Both Men and Women Undergoing Coronary Artery Bypass Graft Surgery
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DOI：
10.1097/00000542-200111000-00008
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发表时间：
2001-11-01
期刊：
影响因子：
8.8
通讯作者：
Dávila-Román, VG
中科院分区：
文献类型：
--
作者：
Hogue, CW;Sundt, T;Dávila-Román, VG
背景资料：尽管一些研究表明，女性和男性对冠状动脉旁路移植术的反应不同，但尚不清楚女性和男性与死亡率相关的变量是否相同。本研究的目的是确定变量的独立相关的死亡率为妇女接受冠状动脉旁路移植术surgery.Methods：单机构的数据进行了前瞻性收集，从5,113例（1,558或30.5%的妇女）接受冠状动脉旁路移植术。根据性别对数据库中的患者特征和手术结局进行了审查。并发症包括低心排综合征（心指数<2.01）。min（-1）（.）m（-2）> 8 h，不考虑治疗），卒中（新发永久性全局或局灶性运动缺陷），Q波心肌梗死，术后房颤，手术死亡率。结果：女性年龄大于男性，且更可能有既往高血压、糖尿病和卒中史。手术死亡率女性高于男性（3.5%比2.5%，P < 0.05）。与男性相比，女性更容易发生术后心肌梗死、中风和低心排血量综合征。当分别对两种性别的数据进行分析时，低心排血量综合征、新发卒中、心肌梗死和心肺转流持续时间与女性和男性的死亡率独立相关。患者年龄与女性死亡风险无关，但与男性相关。然而，当作者结合两种性别的logistic回归分析，年龄性别的相互作用是不显着的（P = 0.266），表明没有足够的证据来断言，年龄对死亡率有不同的影响为男性和女性。结论：这些数据证实，女性冠状动脉旁路移植术后的围手术期死亡率高于男性。心脏和神经系统并发症的发生率较高似乎在很大程度上是妇女手术死亡率较高的原因。与围手术期死亡率独立相关的因素在女性和男性中基本相似。
Background: Despite a number of studies showing that women and men respond to coronary artery bypass graft surgery differently, it is not known whether variables associated with mortality are the same for women and men. The purpose of this study was to identify variables independently associated with mortality for women undergoing coronary artery bypass graft surgery.Methods: Single-institutional data were prospectively collected from 5,113 patients (1,558 or 30.5% women) undergoing coronary artery bypass graft surgery. The database was reviewed for patient characteristics and operative outcomes based on sex. Complications evaluated included low cardiac output syndrome (cardiac index < 2.0 1 (.) min(-1) (.) m(-2) for > 8 h, regardless of treatment), stroke (new permanent global or focal motor deficits), Q-wave myocardial infarction, postoperative atrial fibrillation, and operative mortality.Results: Women were older than men, and they were more likely to have preexisting hypertension, diabetes, and a history of stroke. Operative mortality for women was higher than for men (3.5% vs. 2.5%, P < 0.05). Compared with men, women were more likely to experience a postoperative myocardial infarction, stroke, and low cardiac output syndrome. When performing analysis on data from both sexes separately, low cardiac output syndrome, new stroke, myocardial infarction, and duration of cardiopulmonary bypass were independently associated with mortality for women and men both. Patient age was not independently associated with risk for mortality for women, but it was for men. However, when the authors combined both sexes in the logistic regression analysis, the age-sex Interaction was not significant (P = 0.266), indicating that there was insufficient evidence to assert that age has a different effect on mortality for men and women.Conclusions: These data confirm that women have higher perioperative mortality after coronary artery bypass graft surgery compared with men. A higher frequency of cardiac and neurologic complications seem to account to a large extent for the higher operative mortality for women. Factors independently associated with perioperative mortality are generally similar for women and men.