Operative Outcomes of Women Undergoing Coronary Artery Bypass Surgery in the US, 2011 to 2020
Operative Outcomes of Women Undergoing Coronary Artery Bypass Surgery in the US, 2011 to 2020
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DOI：
10.1001/jamasurg.2022.8156
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发表时间：
2023-03-01
期刊：
影响因子：
16.9
通讯作者：
Habib, Robert H.
中科院分区：
文献类型：
--
作者：
Gaudino, Mario;Chadow, David;Habib, Robert H.
重要性 据报道，与男性相比，接受冠状动脉搭桥手术的女性死亡率和发病率较高，但尚不清楚过去十年中这种差异是否有所缩小。目的 评估 2011 年至 2020 年美国接受冠状动脉搭桥手术的女性结局趋势。设计、设置和参与者 这项在医院进行的回顾性队列研究为胸外科医生协会成人心脏手术数据库提供了资料，纳入了 1297204 名接受初次孤立冠状动脉搭桥手术的患者2011年至2020年。暴露冠状动脉搭桥术。主要结果和措施主要结果是手术死亡率。次要结局是手术死亡率和发病率的综合结果（包括手术死亡率、中风、肾衰竭、再次手术、胸骨深部伤口感染、机械通气时间延长和住院时间延长）。计算主要和次要结局的归因风险（女性与冠状动脉旁路移植结果的关联）。 结果 2011年至2020年间，1297204例患者接受了初次离体冠状动脉旁路移植术，平均年龄为66.0岁，其中317716例为女性（24.5%）。女性未经调整的手术死亡率较高（2.8%；95% CI，2.8-2.9 vs 1.7%；95% CI，1.7-1.7；P
Importance It has been reported that women undergoing coronary artery bypass have higher mortality and morbidity compared with men but it is unclear if the difference has decreased over the last decade.Objective To evaluate trends in outcomes of women undergoing coronary artery bypass in the US from 2011 to 2020.Design, Setting, and Participants This retrospective cohort study at hospitals contributing to the Adult Cardiac Surgery Database of the Society of Thoracic Surgeons included 1297204 patients who underwent primary isolated coronary artery bypass from 2011 to 2020.Exposure Coronary artery bypass.Main Outcomes and Measures The primary outcome was operative mortality. The secondary outcome was the composite of operative mortality and morbidity (including operative mortality, stroke, kidney failure, reoperation, deep sternal wound infection, prolonged mechanical ventilation, and prolonged hospital stay). The attributable risk (the association of female sex with coronary artery bypass grafting outcomes) for the primary and secondary outcomes was calculated.Results Between 2011 and 2020, 1297204 patients underwent primary isolated coronary artery bypass grafting with a mean age of 66.0 years, 317716 of which were women (24.5%). Women had a higher unadjusted operative mortality (2.8%; 95% CI, 2.8-2.9 vs 1.7%; 95% CI, 1.7-1.7; P