Arq. Bras. Cardiol. 2024; 121(8): e20240012
More Hospital Complications in Women after Cabg Even for Reduced Surgical Times: Call to Action for Equity in Quality Improvement
Leonardo Lacava
, Fabiane Letícia de Freitas
, Gabrielle Barbosa Borgomoni
, Pedro Gabriel Melo de Barros e Silva
, Marcelo Arruda Nakazone
, Valquiria Pelisser Campagnucci, Marcos Gradim Tiveron, Luiz Augusto Lisboa
, Fabio Biscegli Jatene
, Omar Asdrúbal Vilca Mejia
Abstract
Background
Analyses of extensive registries indicate adverse outcomes for women undergoing coronary artery bypass grafting (CABG) surgery, while randomized studies often lack representativeness.
Objective
To compare adjusted hospital outcomes between men and women undergoing CABG.
Methods
From July 2017 to June 2019, 3991 patients underwent primary isolated CABG, both electively and urgently, in 5 hospitals in the state of São Paulo, Brazil. To mitigate demographic differences between men and women, populations were adjusted using propensity score matching (PSM). The outcomes considered for analysis were those used by the STS Adult Database. The analyses were performed using R software, with a significance set at p<0.05.
Results
After PSM (1:1), each group included 1089 patients. Regarding intraoperative variables, men exhibited longer cardiopulmonary bypass (CPB) time (p<0.001), surgical time (p<0.001), a higher number of distal anastomoses (p<0.001), and increased use of arterial grafts. Regarding outcomes, women had a higher incidence of deep sternal wound infection (p=0.006), prolonged Intensive Care Unit stay (p=0.002), increased need for an intra-aortic balloon pump (p=0.04), higher blood transfusion rates (p<0.001), higher 30-day hospital readmission rates after surgery (p=0.002) and higher mortality rate (p=0.03).
Conclusions
Although men had longer CPB times, a greater number of arterial grafts, and a greater number of distal anastomoses, immediate results after CABG were poorer in women.
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