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Female Gender is not a Risk Factor for Early Mortality after Coronary Artery Bypass Grafting


1 Divisions of Cardio-Thoracic Surgery, Amrita Institute of Medical Sciences and Research Center, Amrita Viswa Vidyapeetham (Amrita University), Kochi, Kerala, India
2 Biostatistics, Amrita Institute of Medical Sciences and Research Center, Amrita Viswa Vidyapeetham (Amrita University), Kochi, Kerala, India
3 Division of Cardio-Thoracic Surgery, Hospital Cruz Vermelha, Lisbon, Portugal
4 Anesthesiology, Amrita Institute of Medical Sciences and Research Center, Amrita Viswa Vidyapeetham (Amrita University), Kochi, Kerala, India

Correspondence Address:
Praveen Kerala Varma
Division of Cardio-Thoracic Surgery, Amrita Institute of Medical Sciences and Research Center, Amrita University, Kochi, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_27_18

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Year : 2019  |  Volume : 22  |  Issue : 2  |  Page : 187-193

 

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Background: The female gender is considered as a risk factor for morbidity and mortality after coronary artery bypass grafting (CABG). Aim: In this analysis, we assessed the impact of female gender on early outcome after CABG. Study Design: This is a retrospective analysis of data from our center situated in South India. Statistical Analysis: Patients were categorized according to gender and potential differences in pre-operative and post-operative factors were explored. Significant risk factors were then built in a multivariate model to account for differences in predicting gender influence on surgical outcome. Methods: 773 consecutive patients underwent first time CABG between January 2015 and December 2016. 96.77% of cases were performed using off-pump technique. 132 (17.07%) patients were females. These patients formed the study group. Results: The in-house/ 30-day mortality in females was similar to that of males (3.03% vs. 3.12%, p value 0.957). Mediastinitis developed more commonly in females (5.35% vs. 1.30%; p value 0.004) compared to males. There were more re-admissions to hospital for female patients (21.37% in females vs. 10.14% in males, p value <0.001). In multivariate analysis using logistic regression; there was a significant association between age (OR 1.08), chronic obstructive airway disease (OR 4.315), and use of therapeutic antibiotics (OR 6.299), IABP usage (OR 11.18) and renal failure requiring dialysis (OR 28.939) with mortality. Conclusions: Early mortality in females was similar to that of males. Females were associated with higher rate of wound infection and readmission to hospital.






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1 Divisions of Cardio-Thoracic Surgery, Amrita Institute of Medical Sciences and Research Center, Amrita Viswa Vidyapeetham (Amrita University), Kochi, Kerala, India
2 Biostatistics, Amrita Institute of Medical Sciences and Research Center, Amrita Viswa Vidyapeetham (Amrita University), Kochi, Kerala, India
3 Division of Cardio-Thoracic Surgery, Hospital Cruz Vermelha, Lisbon, Portugal
4 Anesthesiology, Amrita Institute of Medical Sciences and Research Center, Amrita Viswa Vidyapeetham (Amrita University), Kochi, Kerala, India

Correspondence Address:
Praveen Kerala Varma
Division of Cardio-Thoracic Surgery, Amrita Institute of Medical Sciences and Research Center, Amrita University, Kochi, Kerala
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_27_18

Rights and Permissions

Background: The female gender is considered as a risk factor for morbidity and mortality after coronary artery bypass grafting (CABG). Aim: In this analysis, we assessed the impact of female gender on early outcome after CABG. Study Design: This is a retrospective analysis of data from our center situated in South India. Statistical Analysis: Patients were categorized according to gender and potential differences in pre-operative and post-operative factors were explored. Significant risk factors were then built in a multivariate model to account for differences in predicting gender influence on surgical outcome. Methods: 773 consecutive patients underwent first time CABG between January 2015 and December 2016. 96.77% of cases were performed using off-pump technique. 132 (17.07%) patients were females. These patients formed the study group. Results: The in-house/ 30-day mortality in females was similar to that of males (3.03% vs. 3.12%, p value 0.957). Mediastinitis developed more commonly in females (5.35% vs. 1.30%; p value 0.004) compared to males. There were more re-admissions to hospital for female patients (21.37% in females vs. 10.14% in males, p value <0.001). In multivariate analysis using logistic regression; there was a significant association between age (OR 1.08), chronic obstructive airway disease (OR 4.315), and use of therapeutic antibiotics (OR 6.299), IABP usage (OR 11.18) and renal failure requiring dialysis (OR 28.939) with mortality. Conclusions: Early mortality in females was similar to that of males. Females were associated with higher rate of wound infection and readmission to hospital.






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