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Excess short-term mortality in women after isolated coronary artery bypass graft surgery

机译：单发冠状动脉搭桥手术后妇女的短期死亡率过高

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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%.
机译：目的女性被认为是孤立的冠状动脉旁路移植术（CABG）手术后不良结局的危险因素。我们评估了孤立性CABG后性别与短期死亡率之间的关联，并评估了女性中“过度”死亡的发生率。方法在2008年1月至2012年12月间，对北德克萨斯州连续13到327例孤立的CABG患者进行了短期死亡率调查。性别与CABG短期死亡率之间的相关性以及通过倾向性调整（由胸外科医师学会认可的危险因素）的广义估计方程模型方法。结果女性的短期死亡率显着高于男性（校正OR = 1.39; 95％CI 1.04至1.86; p = 0.027）。这种明显更高的风险转化为该研究中包括35例“过度”死亡（在该研究队列中占总343例死亡的10％以上），以及约40,000例接受孤立CABG的女性中392例“过度”死亡。每年美国。结论在本研究队列中，与女性相关的较高风险导致女性中有35例“过度”死亡（占死亡总数的10％以上），每年在美国接受单独CABG的女性中有392例“过度”死亡。需要进一步的研究来评估这种性别相关差异的原因机制。这项工作的结果可能有助于制定和实施针对性别的治疗和管理策略，以降低CABG后妇女的死亡率。根据我们的结果，如果这样的工作使女性的短期死亡率与男性的短期死亡率相符，则总的短期死亡率可以降低多达10％。

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