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Original research article
Excess short-term mortality in women after isolated coronary artery bypass graft surgery
  1. Giovanni Filardo1,
  2. Baron L Hamman2,
  3. Benjamin D Pollock1,
  4. Briget da Graca1,
  5. Danielle M Sass1,
  6. Teresa K Phan1,
  7. James Edgerton3,
  8. Syma L Prince4 and
  9. W Steves Ring5
  1. 1Department of Epidemiology, Office of the Chief Quality Officer, Baylor Scott & White Health, Dallas, Texas, USA
  2. 2Department of Cardiothoracic Surgery, Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas, USA
  3. 3The Heart Hospital Baylor, Plano, Texas, USA
  4. 4Cardiopulmonary Research Science & Technology Institute, Dallas, Texas, USA
  5. 5Department of Cardiothoracic Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
  1. Correspondence to Dr Giovanni Filardo; giovanfi{at}baylorhealth.edu

Abstract

Objective Female sex is considered a risk factor for adverse outcomes following isolated coronary artery bypass graft (CABG) surgery. We assessed the association between sex and short-term mortality following isolated CABG, and estimated the ‘excess’ deaths occurring in women.

Methods Short-term mortality was investigated in 13 327 consecutive isolated CABG patients in North Texas between January 2008 and December 2012. The association between sex and CABG short-term mortality, and the excess deaths among women were assessed via a propensity-adjusted (by Society of Thoracic Surgeons-recognised risk factors) generalised estimating equations model approach.

Results Short-term mortality was significantly higher in women than men (adjusted OR=1.39; 95% CI 1.04 to 1.86; p=0.027). This significantly greater risk translates into 35 ‘excess’ deaths among women included in this study (>10% of the total 343 deaths in the study cohort) and into 392 ‘excess’ deaths among the ∼40 000 women undergoing isolated CABG in the USA each year.

Conclusions The higher risk associated with female sex lead to 35 ‘excess’ deaths in women in this study cohort (over 10% of the total deaths) and to 392 ‘excess’ deaths among women undergoing isolated CABG in the USA each year. Further research is needed to assess the causal mechanisms underlying this sex-related difference. Results of such work could inform the development and implementation of sex-specific treatment and management strategies to reduce women's mortality following CABG. Based on our results, if such work brought women's short-term mortality into line with men's, total short-term mortality could be reduced by up to 10%.

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This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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