Female sex was associated with significantly higher 10-year mortality compared to male sex following isolated mitral valve replacement (36.3% vs. 30.5%; p=0.013).
Cohort (n=1,629)
No
Does female sex increase postoperative morbidity and 10-year mortality in patients undergoing isolated mitral valve replacement?
Female sex is independently associated with higher postoperative morbidity and 10-year mortality following isolated mitral valve replacement, highlighting the need for careful long-term risk assessment in women.
Absolute Event Rate: 36.3% vs 30.5%
p-value: p=0.013
Objective: The present study aimed to determine clinical and surgical variables associated with postoperative morbidity and 10-year mortality in isolated mitral valve replacement (MVR) and to assess the association between sex and postoperative outcomes. Materials and Methods: A total of 1629 patients undergoing isolated MVR in one center during the period between January 2000 and December 2015 were retrospectively analyzed. Hospital records provided demographic, clinical, echocardiographic, and operative data. Cox regression analyses were used to determine factors associated with postoperative morbidity and long-term mortality. The Kaplan–Meier method was used to analyze long-term survival, and the log-rank test was used to compare the groups. Results: A total of 866 (53.1%) patients were male and 763 (46.9%) were female, and the average age was 63.8 ± 10.9 years. There were no significant differences in female and male patients regarding basic demographic and clinical characteristics. The first 30-day in-hospital morbidity rate was also significantly greater in women than in men (25.7% vs. 20.6%; p = 0.015). The in-hospital mortality was more prevalent among women (5.0% vs. 3.0%; p = 0.043). Age, sex (female), diabetes mellitus, pulmonary hypertension, chronic obstructive pulmonary disease, critical preoperative condition, high body mass index, longer cardiopulmonary bypass time, and low left ventricular functioning were significantly associated with postoperative morbidity in multivariable analysis. The total mortality rate during a 10-year follow-up was 33.2%, which was considerably higher among women compared to men (36.3 vs. 30.5; p = 0.013). Kaplan–Meier analysis demonstrated significantly lower long-term survival in female patients (log-rank p = 0.011). Conclusion: Morbidity and mortality following isolated MVR are closely related to patient-related factors. Female sex showed a significant adjusted association with higher 10-year mortality in multivariable analysis, warranting careful long-term risk assessment in female patients.
Önder et al. (Sun,) conducted a cohort in Isolated mitral valve replacement (MVR) (n=1,629). Female sex vs. Male sex was evaluated on 10-year mortality (p=0.013). Female sex was associated with significantly higher 10-year mortality compared to male sex following isolated mitral valve replacement (36.3% vs. 30.5%; p=0.013).
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