Women undergoing mitral valve surgery were more likely to undergo valve replacement rather than repair compared to men (OR 1.78; 95% CI 1.64-1.93; P=0.0001).
Observational
Yes
Does female sex influence procedure selection and hospital mortality in patients undergoing mitral valve surgery?
Women undergoing mitral valve surgery are significantly less likely to receive valve repair compared to men, a disparity that persists even after adjusting for their worse baseline clinical profiles.
Odds Ratio: 1.78 (95% CI 1.64–1.93)
p-value: p=0.0001
BACKGROUND: There is a paucity of data on sex differences in procedure selection and outcomes of patients undergoing mitral valve surgery. METHODS AND RESULTS: The National Inpatient Sample database from 2005 to 2008 was searched to identify patients ≥30 years of age who underwent mitral valve repair or replacement (ICD-9-CM codes 35.12, 35.23, and 35.24). Women constituted 51.6% of the patients, and they were older, were less affluent, had higher values for the Charlson comorbidity index, and more often presented on an urgent/emergent basis. Women underwent repair less often than men (37.9% versus 55.9%, P < .001) and more often underwent concomitant tricuspid surgery or a Maze procedure. After adjustment for propensity scores, women were more likely to undergo replacement (odds ratio, 1.78; 95% confidence interval, 1.64-1.93; P = .0001), they had longer lengths of stay, and less favorable disposition. Among the patients who underwent mitral valve repair, women had a higher hospital mortality (2.06% versus 1.36%, P = .0328). After adjustment for propensity scores and concomitant procedures, this relationship was no longer statistically significant. CONCLUSIONS: Women are less likely than men to receive mitral valve repair. Although the higher hospital mortality of women presenting for mitral valve surgery was accounted for by their worse preoperative profiles, this sex disparity reflects the current reality in surgical practice and identifies an important area for future improvement in the care of patients with valvular heart disease.
Vassileva et al. (Thu,) conducted a observational in Mitral valve disease requiring surgery. Female sex vs. Male sex was evaluated on Mitral valve replacement (OR 1.78, 95% CI 1.64-1.93, p=0.0001). Women undergoing mitral valve surgery were more likely to undergo valve replacement rather than repair compared to men (OR 1.78; 95% CI 1.64-1.93; P=0.0001).