Key result
Female sex was associated with significantly higher postoperative mortality (14.2% vs 9.4%, p=0.049) and morbidity compared to male sex in adults undergoing cardiac surgery.
Why the study?
Female sex is considered an independent predictor for mortality and morbidity after cardiac surgery, prompting an evaluation of outcomes between males and females in a Saudi tertiary referral hospital.
Does female sex increase the risk of postoperative mortality and morbidity in adult patients undergoing cardiac surgery?
Observational (n=925)
No
Does female sex increase the risk of postoperative mortality and morbidity in adult patients undergoing cardiac surgery?
Absolute Event Rate: 14.2% vs 9.4%
p-value: p=0.049
Female patients undergoing cardiac surgery in Saudi Arabia face significantly higher risks of short-term mortality and morbidity compared to males, highlighting a need for earlier diagnosis and referral.
May indicate higher perioperative risk for women; hypothesis-generating and requires prospective validation before influencing practice.
BACKGROUND: Female sex is considered an independent predictor for mortality and morbidity following cardiac surgery. This study is to review the outcomes of adult cardiac surgery between males and females in a Saudi tertiary referral hospital. METHOD: This was a retrospective study for 925 adult patients operated on for ischemic coronary artery disease and acquired aortic and mitral valvular heart disease from 2015 to August 2023. We analyzed patient characteristics, intraoperative data, and postoperative results to compare outcomes between males and females. RESULTS: Preoperative risk factors were not significantly different in both groups. Postoperative outcomes showed gender-based differences. In univariable analysis, females, compared to males, had significantly greater odds of prolonged postoperative ventilation (>24 hours), 32.8% of females compared to 20.7% of males (p < 0.001). Also, sternal wound infection was notably higher among females (13.3%) (p < 0.001). Mortality also exhibited a significant association, with 14.2% of females experiencing mortality compared to 9.4% of males (p = 0.049). In the multivariable analysis for elevated postoperative troponin, the use of pre-operative intra-aortic balloon pump, urgent/emergent surgery, elevated pre-operative troponin and combined bypass grafting with valve surgery, were also predictive of higher post-operative troponin concentrations (beta = 0.43, 95% CI: 0.25 to 0.62, p < 0.001). CONCLUSION: Females in Saudi Arabia have an increased risk of short-term morbidity and mortality after cardiac surgery compared to males. Vague and delayed presentation and then the late diagnosis and referral are likely the main contributing factors. This highlights the need to implement preoperative measures to improve early diagnosis and referral to eliminate gender bias.
No takes yet. Share an insight, caveat, or question.
Al‐Ebrahim et al. (2023) conducted an observational in Ischemic coronary artery disease and acquired aortic and mitral valvular heart disease (n=925). Female sex vs. Male sex was evaluated on Mortality (p=0.049). Female sex was associated with significantly higher postoperative mortality (14.2% vs 9.4%, p=0.049) and morbidity compared to male sex in adults undergoing cardiac surgery.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: