Is the female gender an independent predictor of adverse outcome after off-pump coronary artery bypass grafting?

The female gender is an independent predictor of adverse outcome after conventional coronary artery bypass grafting using cardiopulmonary bypass. The aim of this study is to assess the effect of the female gender on the outcome after off-pump coronary artery bypass (OPCAB) surgery. This study is a r...

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Veröffentlicht in:The Annals of thoracic surgery 2003-04, Vol.75 (4), p.1153-1160
Hauptverfasser: Athanasiou, Thanos, Al-Ruzzeh, Sharif, Stanbridge, Rex Del, Casula, Roberto P, Glenville, Brian E, Amrani, Mohamed
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container_issue 4
container_start_page 1153
container_title The Annals of thoracic surgery
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creator Athanasiou, Thanos
Al-Ruzzeh, Sharif
Stanbridge, Rex Del
Casula, Roberto P
Glenville, Brian E
Amrani, Mohamed
description The female gender is an independent predictor of adverse outcome after conventional coronary artery bypass grafting using cardiopulmonary bypass. The aim of this study is to assess the effect of the female gender on the outcome after off-pump coronary artery bypass (OPCAB) surgery. This study is a retrospective review of 413 consecutive patients (181 women and 232 men) who underwent OPCAB between January 1999 and May 2001. Adverse outcomes were divided into minor adverse outcomes (MINAO), major adverse outcomes (MAJAO), and prolonged length of stay (PLOS) more than 7 days. MINAO included atrial fibrillation, respiratory complications except adult respiratory distress syndrome, and any wound infection except mediastinitis. MAJAO included stroke, myocardial infarction, renal failure, adult respiratory distress syndrome, mediastinitis, low cardiac output, mechanical ventilation more than 24 hours, intensive therapy unit stay more than 24 hours, gastrointestinal complications, cardiorespiratory arrest, and mortality within 30 days. Preoperative and intraoperative variables were evaluated as predictors of MINAO, MAJAO, and PLOS by univariate and multivariate analyses. The groups were matched for age and Parsonnet score–predicted mortality. However, the women had a higher incidence of chronic obstructive airway disease ( p = 0.04), diabetes ( p = 0.01), obesity ( p = 0.000), peripheral vascular disease ( p = 0.000), hypertension ( p = 0.000), unstable angina ( p = 0.005), history of previous failed nonsurgical intervention ( p = 0.02), and nonelective operation ( p = 0.000). There were a fewer number of grafts performed in the female group (2.8 vs 3.4, p = 0.000), with the circumflex territory being revascularised less frequently ( p = 0.001). Univariate analysis identified the female gender to be a predictor of only MINAO ( p = 0.001) and PLOS ( p = 0.000). However, with multivariate analysis, female gender was not found to be an independent predictor of MINAO, MAJAO, or PLOS. In OPCAB, the female gender is not an independent predictor of MINAO, MAJAO, or PLOS.
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The aim of this study is to assess the effect of the female gender on the outcome after off-pump coronary artery bypass (OPCAB) surgery. This study is a retrospective review of 413 consecutive patients (181 women and 232 men) who underwent OPCAB between January 1999 and May 2001. Adverse outcomes were divided into minor adverse outcomes (MINAO), major adverse outcomes (MAJAO), and prolonged length of stay (PLOS) more than 7 days. MINAO included atrial fibrillation, respiratory complications except adult respiratory distress syndrome, and any wound infection except mediastinitis. MAJAO included stroke, myocardial infarction, renal failure, adult respiratory distress syndrome, mediastinitis, low cardiac output, mechanical ventilation more than 24 hours, intensive therapy unit stay more than 24 hours, gastrointestinal complications, cardiorespiratory arrest, and mortality within 30 days. Preoperative and intraoperative variables were evaluated as predictors of MINAO, MAJAO, and PLOS by univariate and multivariate analyses. The groups were matched for age and Parsonnet score–predicted mortality. However, the women had a higher incidence of chronic obstructive airway disease ( p = 0.04), diabetes ( p = 0.01), obesity ( p = 0.000), peripheral vascular disease ( p = 0.000), hypertension ( p = 0.000), unstable angina ( p = 0.005), history of previous failed nonsurgical intervention ( p = 0.02), and nonelective operation ( p = 0.000). There were a fewer number of grafts performed in the female group (2.8 vs 3.4, p = 0.000), with the circumflex territory being revascularised less frequently ( p = 0.001). Univariate analysis identified the female gender to be a predictor of only MINAO ( p = 0.001) and PLOS ( p = 0.000). However, with multivariate analysis, female gender was not found to be an independent predictor of MINAO, MAJAO, or PLOS. 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The aim of this study is to assess the effect of the female gender on the outcome after off-pump coronary artery bypass (OPCAB) surgery. This study is a retrospective review of 413 consecutive patients (181 women and 232 men) who underwent OPCAB between January 1999 and May 2001. Adverse outcomes were divided into minor adverse outcomes (MINAO), major adverse outcomes (MAJAO), and prolonged length of stay (PLOS) more than 7 days. MINAO included atrial fibrillation, respiratory complications except adult respiratory distress syndrome, and any wound infection except mediastinitis. MAJAO included stroke, myocardial infarction, renal failure, adult respiratory distress syndrome, mediastinitis, low cardiac output, mechanical ventilation more than 24 hours, intensive therapy unit stay more than 24 hours, gastrointestinal complications, cardiorespiratory arrest, and mortality within 30 days. Preoperative and intraoperative variables were evaluated as predictors of MINAO, MAJAO, and PLOS by univariate and multivariate analyses. The groups were matched for age and Parsonnet score–predicted mortality. However, the women had a higher incidence of chronic obstructive airway disease ( p = 0.04), diabetes ( p = 0.01), obesity ( p = 0.000), peripheral vascular disease ( p = 0.000), hypertension ( p = 0.000), unstable angina ( p = 0.005), history of previous failed nonsurgical intervention ( p = 0.02), and nonelective operation ( p = 0.000). There were a fewer number of grafts performed in the female group (2.8 vs 3.4, p = 0.000), with the circumflex territory being revascularised less frequently ( p = 0.001). Univariate analysis identified the female gender to be a predictor of only MINAO ( p = 0.001) and PLOS ( p = 0.000). However, with multivariate analysis, female gender was not found to be an independent predictor of MINAO, MAJAO, or PLOS. 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The aim of this study is to assess the effect of the female gender on the outcome after off-pump coronary artery bypass (OPCAB) surgery. This study is a retrospective review of 413 consecutive patients (181 women and 232 men) who underwent OPCAB between January 1999 and May 2001. Adverse outcomes were divided into minor adverse outcomes (MINAO), major adverse outcomes (MAJAO), and prolonged length of stay (PLOS) more than 7 days. MINAO included atrial fibrillation, respiratory complications except adult respiratory distress syndrome, and any wound infection except mediastinitis. MAJAO included stroke, myocardial infarction, renal failure, adult respiratory distress syndrome, mediastinitis, low cardiac output, mechanical ventilation more than 24 hours, intensive therapy unit stay more than 24 hours, gastrointestinal complications, cardiorespiratory arrest, and mortality within 30 days. Preoperative and intraoperative variables were evaluated as predictors of MINAO, MAJAO, and PLOS by univariate and multivariate analyses. The groups were matched for age and Parsonnet score–predicted mortality. However, the women had a higher incidence of chronic obstructive airway disease ( p = 0.04), diabetes ( p = 0.01), obesity ( p = 0.000), peripheral vascular disease ( p = 0.000), hypertension ( p = 0.000), unstable angina ( p = 0.005), history of previous failed nonsurgical intervention ( p = 0.02), and nonelective operation ( p = 0.000). There were a fewer number of grafts performed in the female group (2.8 vs 3.4, p = 0.000), with the circumflex territory being revascularised less frequently ( p = 0.001). Univariate analysis identified the female gender to be a predictor of only MINAO ( p = 0.001) and PLOS ( p = 0.000). However, with multivariate analysis, female gender was not found to be an independent predictor of MINAO, MAJAO, or PLOS. In OPCAB, the female gender is not an independent predictor of MINAO, MAJAO, or PLOS.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>12683554</pmid><doi>10.1016/S0003-4975(02)04757-4</doi><tpages>8</tpages></addata></record>
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source MEDLINE; Access via ScienceDirect (Elsevier); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
subjects Biological and medical sciences
Coronary Artery Bypass - methods
Female
Humans
Length of Stay
Male
Medical sciences
Middle Aged
Postoperative Complications
Prognosis
Retrospective Studies
Sex Factors
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Treatment Outcome
title Is the female gender an independent predictor of adverse outcome after off-pump coronary artery bypass grafting?
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