Key result
Female sex links to ~51% higher in-hospital CABG mortality but this risk disappears after matching.
Why the study?
Women undergoing CABG tend to have worse in-hospital outcomes, but whether these disparities stem from gender itself or confounding clinical factors remains unclear.
Is female gender associated with higher in-hospital mortality in patients undergoing coronary artery bypass grafting?
Observational (n=9,845)
No
Is female gender associated with higher in-hospital mortality in patients undergoing coronary artery bypass grafting?
Effect estimate: OR 1.51 (95% CI 1.15-1.99)
Absolute Event Rate: 4.8% vs 2.4%
p-value: p=0.003
When clinical factors are matched, the apparent higher in-hospital mortality in women undergoing CABG disappears, suggesting differences are driven by baseline clinical profile rather than gender itself.
Baseline risk factors, not gender, explain higher CABG mortality in women; leaves open unmeasured confounders.
Background Women undergoing coronary artery bypass grafting (CABG) tend to have worse in-hospital outcomes, but it is unclear whether these differences are due to gender or to clinical factors. Objective To compare in-hospital outcomes between women and men undergoing CABG. Methods This was a single-center, retrospective observational study analyzing data from 9,845 patients who underwent CABG between 1995 and 2022, of whom 1,947 (19.8%) were women. To evaluate female gender as a prognostic factor for in-hospital mortality, we used descriptive statistics, univariate and multivariate logistic regression, and propensity score matching. The significance level was set at 5%. Results Women were older (66.7 vs 62.19 years, p<0.001), had lower body mass index (26.91 vs 27.64, p<0.001), and had a higher prevalence of diabetes mellitus (34.0% vs 31.6%, p=0.045). They also had longer hospital stays (14.84 vs 13.13 days, p<0.001) and higher operative mortality (4.8% vs 2.4%, p<0.001). In logistic regression, female gender was associated with higher mortality (OR=1.51; 95% CI: 1.15-1.99; p=0.003). After matching, there was no significant difference in mortality (OR=1.20; 95% CI: 0.88-1.64; p=0.241), but length of hospital stay remained longer in women. Conclusion When clinical factors were matched between men and women, the mortality difference disappeared. This suggests that targeted interventions to reduce disparities may help improve mortality outcomes in women undergoing CABG.
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Goncharov et al. (2025) conducted an observational in Coronary Artery Disease (n=9,845). Female gender vs. Male gender was evaluated on In-hospital mortality (OR 1.51, 95% CI 1.15-1.99, p=0.003). Female gender was associated with a higher risk of in-hospital mortality after coronary artery bypass grafting in multivariate analysis (OR 1.51), although this difference disappeared after propensity score matching.
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