Female gender was an independent predictor of 30-day mortality in patients undergoing isolated surgical aortic valve replacement (HR 2.2; 95% CI 0.98-5.2; P=0.05), but not for late mortality.
Cohort (n=2,197)
No
Does female sex affect 30-day and late mortality in patients undergoing isolated surgical aortic valve replacement?
Female patients undergoing isolated SAVR present older and with higher surgical risk, and female sex is an independent predictor of 30-day mortality but not late mortality.
Effect estimate: HR 2.2 (95% CI 0.98 to 5.2)
Absolute Event Rate: 4.4% vs 1.6%
p-value: p=0.05
OBJECTIVES: The aim of this study is to evaluate gender-related differences in clinical presentation and mortality in patients undergoing isolated surgical aortic valve replacement (SAVR). METHODS: We performed a retrospective analysis of all patients undergoing isolated SAVR from 2000 to 2011 in our center. Patient data were compared with regard to gender including baseline characteristics, 30-day, and late mortality. Kaplan-Meier survival curves were used to analyze long-term survival up to 10 years follow-up. Independent risk factors for 30-day and late mortality were identified using a Cox regression model. RESULTS: Two thousand one hundred ninety-seven patients were included, 1290 (58.7%) male patients and 907 (41.3%) female patients. Female patients were older (70 ± 11 vs. 64 ± 13 years, p < 0.001), presented with higher logistic EuroSCORE (7.5 ± 5.8 vs. 5.6 ± 6%, p = 0.006), and more common NYHA class III or IV (71 vs. 65%, p = 0.05). Male patients presented more often with LV dysfunction (7.5 vs. 2.8%, p < 0.001) and endocarditis (4.1 vs. 1.7%, p < 0.001) than female patients. Intraoperatively, female patients were more likely to have had a complete sternotomy (65 vs. 52%, p < 0.001) and SAVR with a bioprosthesis (87 vs. 78%, p < 0.001). Female patients exhibited a higher 30-day mortality (4.4 vs. 1.6%, p < 0.001) and late mortality (13 vs. 9.6%, p = 0.04) than male patients. After adjustment for baseline characteristics, only female gender was an independent predictor for 30-day mortality (HR 2.2, 95% CI 0.98 to 5.2, p = 0.05) and age as independent predictor for late mortality (HR 1.07, 95% CI 1.03 to 1.1, p < 0.001). CONCLUSION: Female patients were older and sicker and may therefore exhibit higher 30-day and late mortality than male patients. Female gender per se was a predictor for 30-day but not for late mortality.
Elhmidi et al. (Mon,) conducted a cohort in isolated surgical aortic valve replacement (SAVR) (n=2,197). Female gender vs. Male gender was evaluated on 30-day mortality (HR 2.2, 95% CI 0.98 to 5.2, p=0.05). Female gender was an independent predictor of 30-day mortality in patients undergoing isolated surgical aortic valve replacement (HR 2.2; 95% CI 0.98-5.2; P=0.05), but not for late mortality.