Sex Differences in Outcomes After Elective and Acute Aortic Surgery-A Single-Centre Experience over the Last Two Decades
Recent studies show conflicting results regarding sex-related differences in outcomes following aortic surgery. This study primarily evaluated 20-year mortality rates, along with 30-day and one- and five-year rates, and postoperative complications in female and male patients who underwent elective a...
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| Veröffentlicht in: | Journal of clinical medicine 2024-10, Vol.13 (21), p.6313 |
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| creator | Strypet, Magnus Bozic, Caitlin Mansvelder, Floor J Breel, Jennifer S Jansen, Evert K de Klerk, Eline S López González, Desiré E Hermanns, Henning Eberl, Susanne |
| description | Recent studies show conflicting results regarding sex-related differences in outcomes following aortic surgery. This study primarily evaluated 20-year mortality rates, along with 30-day and one- and five-year rates, and postoperative complications in female and male patients who underwent elective and acute ascending aortic surgery at a tertiary care centre.
This retrospective observational study analysed data from 676 adult patients who underwent ascending aortic surgery in Amsterdam UMC, between January 2001 and December 2020. Descriptive statistics, Fisher's Exact test, Kaplan-Meier survival analysis, and logistic regression were used to assess differences in mortality rates.
Patient characteristics for elective and acute procedures were different. Females were generally older (elective: 69 vs. 62 years,
< 0.001, acute: 70 vs. 62 years,
= 0.002), with smaller body surface area (elective/acute: 1.8 vs. 2.1 m
,
< 0.001), lower preoperative haemoglobin (elective: 8.3 vs. 8.9 mmol/L,
< 0.001, acute: 7.8 vs. 8.4 mmol/L,
< 0.001) and estimated glomerular filtration rate (elective: 64 vs. 91 mL/min,
< 0.001; acute: 67 vs. 83 mL/min,
= 0.004). Females undergoing elective procedures had a lower body mass index (25.0 vs. 26.6 kg/m
,
= 0.006), better left ventricle function (
= 0.048) and higher incidence of chronic obstructive pulmonary disease (15 vs. 8%,
= 0.032). In elective procedures, the 20-year mortality rate (49% vs. 30%,
< 0.001) was significantly higher in females, especially those under 60 years (OR of 3.158 [1.2-8.6],
= 0.024). Mortality rates up to one year were comparable. Five-year mortality rate (26% vs. 16%,
= 0.027) was higher. Females had longer ventilation times (32% vs. 15%,
< 0.001) and intensive care unit stays (2 vs. 1 days,
= 0.005). For acute procedures, morbidity and mortality rates were comparable between sexes.
Females under 60, undergoing elective ascending aortic surgery showed higher long-term all-cause mortality rates. Implementing sex-specific management strategies and extended follow-up could be essential for improving outcomes in this group. |
| doi_str_mv | 10.3390/jcm13216313 |
| format | Article |
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This retrospective observational study analysed data from 676 adult patients who underwent ascending aortic surgery in Amsterdam UMC, between January 2001 and December 2020. Descriptive statistics, Fisher's Exact test, Kaplan-Meier survival analysis, and logistic regression were used to assess differences in mortality rates.
Patient characteristics for elective and acute procedures were different. Females were generally older (elective: 69 vs. 62 years,
< 0.001, acute: 70 vs. 62 years,
= 0.002), with smaller body surface area (elective/acute: 1.8 vs. 2.1 m
,
< 0.001), lower preoperative haemoglobin (elective: 8.3 vs. 8.9 mmol/L,
< 0.001, acute: 7.8 vs. 8.4 mmol/L,
< 0.001) and estimated glomerular filtration rate (elective: 64 vs. 91 mL/min,
< 0.001; acute: 67 vs. 83 mL/min,
= 0.004). Females undergoing elective procedures had a lower body mass index (25.0 vs. 26.6 kg/m
,
= 0.006), better left ventricle function (
= 0.048) and higher incidence of chronic obstructive pulmonary disease (15 vs. 8%,
= 0.032). In elective procedures, the 20-year mortality rate (49% vs. 30%,
< 0.001) was significantly higher in females, especially those under 60 years (OR of 3.158 [1.2-8.6],
= 0.024). Mortality rates up to one year were comparable. Five-year mortality rate (26% vs. 16%,
= 0.027) was higher. Females had longer ventilation times (32% vs. 15%,
< 0.001) and intensive care unit stays (2 vs. 1 days,
= 0.005). For acute procedures, morbidity and mortality rates were comparable between sexes.
Females under 60, undergoing elective ascending aortic surgery showed higher long-term all-cause mortality rates. Implementing sex-specific management strategies and extended follow-up could be essential for improving outcomes in this group.]]></description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm13216313</identifier><identifier>PMID: 39518452</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Angioplasty ; Body mass index ; Cardiac arrhythmia ; Chronic obstructive pulmonary disease ; Coronary vessels ; Elective surgery ; Females ; Gender differences ; Heart ; Hemoglobin ; Hospitals ; Intensive care ; Males ; Mortality ; Patients ; Quality control ; Sexes ; Statistical analysis ; Surgeons ; Surgery ; Surgical outcomes ; Surgical techniques ; Transient ischemic attack</subject><ispartof>Journal of clinical medicine, 2024-10, Vol.13 (21), p.6313</ispartof><rights>COPYRIGHT 2024 MDPI AG</rights><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 by the authors. 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c365t-9d4b36c3f2c976939e2ea20b6158494bbcd5d095d94baffe7a0f573d67acd8e3</cites><orcidid>0000-0001-5754-1850 ; 0009-0003-3543-1230 ; 0000-0002-4297-495X ; 0009-0000-2357-6342 ; 0000-0002-9322-4577 ; 0009-0009-9378-4812 ; 0000-0002-6609-5888</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546913/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546913/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39518452$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Strypet, Magnus</creatorcontrib><creatorcontrib>Bozic, Caitlin</creatorcontrib><creatorcontrib>Mansvelder, Floor J</creatorcontrib><creatorcontrib>Breel, Jennifer S</creatorcontrib><creatorcontrib>Jansen, Evert K</creatorcontrib><creatorcontrib>de Klerk, Eline S</creatorcontrib><creatorcontrib>López González, Desiré E</creatorcontrib><creatorcontrib>Hermanns, Henning</creatorcontrib><creatorcontrib>Eberl, Susanne</creatorcontrib><title>Sex Differences in Outcomes After Elective and Acute Aortic Surgery-A Single-Centre Experience over the Last Two Decades</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description><![CDATA[Recent studies show conflicting results regarding sex-related differences in outcomes following aortic surgery. This study primarily evaluated 20-year mortality rates, along with 30-day and one- and five-year rates, and postoperative complications in female and male patients who underwent elective and acute ascending aortic surgery at a tertiary care centre.
This retrospective observational study analysed data from 676 adult patients who underwent ascending aortic surgery in Amsterdam UMC, between January 2001 and December 2020. Descriptive statistics, Fisher's Exact test, Kaplan-Meier survival analysis, and logistic regression were used to assess differences in mortality rates.
Patient characteristics for elective and acute procedures were different. Females were generally older (elective: 69 vs. 62 years,
< 0.001, acute: 70 vs. 62 years,
= 0.002), with smaller body surface area (elective/acute: 1.8 vs. 2.1 m
,
< 0.001), lower preoperative haemoglobin (elective: 8.3 vs. 8.9 mmol/L,
< 0.001, acute: 7.8 vs. 8.4 mmol/L,
< 0.001) and estimated glomerular filtration rate (elective: 64 vs. 91 mL/min,
< 0.001; acute: 67 vs. 83 mL/min,
= 0.004). Females undergoing elective procedures had a lower body mass index (25.0 vs. 26.6 kg/m
,
= 0.006), better left ventricle function (
= 0.048) and higher incidence of chronic obstructive pulmonary disease (15 vs. 8%,
= 0.032). In elective procedures, the 20-year mortality rate (49% vs. 30%,
< 0.001) was significantly higher in females, especially those under 60 years (OR of 3.158 [1.2-8.6],
= 0.024). Mortality rates up to one year were comparable. Five-year mortality rate (26% vs. 16%,
= 0.027) was higher. Females had longer ventilation times (32% vs. 15%,
< 0.001) and intensive care unit stays (2 vs. 1 days,
= 0.005). For acute procedures, morbidity and mortality rates were comparable between sexes.
Females under 60, undergoing elective ascending aortic surgery showed higher long-term all-cause mortality rates. Implementing sex-specific management strategies and extended follow-up could be essential for improving outcomes in this group.]]></description><subject>Angioplasty</subject><subject>Body mass index</subject><subject>Cardiac arrhythmia</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Coronary vessels</subject><subject>Elective surgery</subject><subject>Females</subject><subject>Gender differences</subject><subject>Heart</subject><subject>Hemoglobin</subject><subject>Hospitals</subject><subject>Intensive care</subject><subject>Males</subject><subject>Mortality</subject><subject>Patients</subject><subject>Quality control</subject><subject>Sexes</subject><subject>Statistical analysis</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Surgical techniques</subject><subject>Transient ischemic attack</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNptkkFv2yAUgK1p01p1Pe0-Ie0yaXIHBmxzmqw0WydF6iG5I4yfUyIbMsBp-u-H1a5Np3HhCT4-3nt6WfaR4CtKBf620yOhBSkpoW-y8wJXVY5pTd-exGfZZQg7nFZds4JU77MzKjipGS_Os-Majuja9D14sBoCMhbdTlG7McVNH8Gj5QA6mgMgZTvU6CkCapyPRqP15LfgH_IGrY3dDpAvwEYPaHncgzezD7lDMsQ7QCsVItrcO3QNWnUQPmTvejUEuHzaL7LNj-VmcZOvbn_-WjSrXNOSx1x0rKWlpn2hRVUKKqAAVeC2JLxmgrWt7niHBe9SrFIVlcI9r2hXVkp3NdCL7Pujdj-1I3R6TlANcu_NqPyDdMrI1zfW3MmtO0hCOCsFocnw5cng3e8JQpSjCRqGQVlwU5CUFHXFGCc8oZ__QXdu8jaVN1MlZkXK-YXaqgGksb1LH-tZKps6WRgXhCTq6j-Umns3Gu0s9Cadv3rw9fGB9i4ED_1zkQTLeVbkyawk-tNpX57Zv5NB_wAqa7jc</recordid><startdate>20241022</startdate><enddate>20241022</enddate><creator>Strypet, Magnus</creator><creator>Bozic, Caitlin</creator><creator>Mansvelder, Floor J</creator><creator>Breel, Jennifer S</creator><creator>Jansen, Evert K</creator><creator>de Klerk, Eline S</creator><creator>López González, Desiré E</creator><creator>Hermanns, Henning</creator><creator>Eberl, Susanne</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5754-1850</orcidid><orcidid>https://orcid.org/0009-0003-3543-1230</orcidid><orcidid>https://orcid.org/0000-0002-4297-495X</orcidid><orcidid>https://orcid.org/0009-0000-2357-6342</orcidid><orcidid>https://orcid.org/0000-0002-9322-4577</orcidid><orcidid>https://orcid.org/0009-0009-9378-4812</orcidid><orcidid>https://orcid.org/0000-0002-6609-5888</orcidid></search><sort><creationdate>20241022</creationdate><title>Sex Differences in Outcomes After Elective and Acute Aortic Surgery-A Single-Centre Experience over the Last Two Decades</title><author>Strypet, Magnus ; Bozic, Caitlin ; Mansvelder, Floor J ; Breel, Jennifer S ; Jansen, Evert K ; de Klerk, Eline S ; López González, Desiré E ; Hermanns, Henning ; Eberl, Susanne</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-9d4b36c3f2c976939e2ea20b6158494bbcd5d095d94baffe7a0f573d67acd8e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Angioplasty</topic><topic>Body mass index</topic><topic>Cardiac arrhythmia</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Coronary vessels</topic><topic>Elective surgery</topic><topic>Females</topic><topic>Gender differences</topic><topic>Heart</topic><topic>Hemoglobin</topic><topic>Hospitals</topic><topic>Intensive care</topic><topic>Males</topic><topic>Mortality</topic><topic>Patients</topic><topic>Quality control</topic><topic>Sexes</topic><topic>Statistical analysis</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Surgical techniques</topic><topic>Transient ischemic attack</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Strypet, Magnus</creatorcontrib><creatorcontrib>Bozic, Caitlin</creatorcontrib><creatorcontrib>Mansvelder, Floor J</creatorcontrib><creatorcontrib>Breel, Jennifer S</creatorcontrib><creatorcontrib>Jansen, Evert K</creatorcontrib><creatorcontrib>de Klerk, Eline S</creatorcontrib><creatorcontrib>López González, Desiré E</creatorcontrib><creatorcontrib>Hermanns, Henning</creatorcontrib><creatorcontrib>Eberl, Susanne</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Strypet, Magnus</au><au>Bozic, Caitlin</au><au>Mansvelder, Floor J</au><au>Breel, Jennifer S</au><au>Jansen, Evert K</au><au>de Klerk, Eline S</au><au>López González, Desiré E</au><au>Hermanns, Henning</au><au>Eberl, Susanne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sex Differences in Outcomes After Elective and Acute Aortic Surgery-A Single-Centre Experience over the Last Two Decades</atitle><jtitle>Journal of clinical medicine</jtitle><addtitle>J Clin Med</addtitle><date>2024-10-22</date><risdate>2024</risdate><volume>13</volume><issue>21</issue><spage>6313</spage><pages>6313-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract><![CDATA[Recent studies show conflicting results regarding sex-related differences in outcomes following aortic surgery. This study primarily evaluated 20-year mortality rates, along with 30-day and one- and five-year rates, and postoperative complications in female and male patients who underwent elective and acute ascending aortic surgery at a tertiary care centre.
This retrospective observational study analysed data from 676 adult patients who underwent ascending aortic surgery in Amsterdam UMC, between January 2001 and December 2020. Descriptive statistics, Fisher's Exact test, Kaplan-Meier survival analysis, and logistic regression were used to assess differences in mortality rates.
Patient characteristics for elective and acute procedures were different. Females were generally older (elective: 69 vs. 62 years,
< 0.001, acute: 70 vs. 62 years,
= 0.002), with smaller body surface area (elective/acute: 1.8 vs. 2.1 m
,
< 0.001), lower preoperative haemoglobin (elective: 8.3 vs. 8.9 mmol/L,
< 0.001, acute: 7.8 vs. 8.4 mmol/L,
< 0.001) and estimated glomerular filtration rate (elective: 64 vs. 91 mL/min,
< 0.001; acute: 67 vs. 83 mL/min,
= 0.004). Females undergoing elective procedures had a lower body mass index (25.0 vs. 26.6 kg/m
,
= 0.006), better left ventricle function (
= 0.048) and higher incidence of chronic obstructive pulmonary disease (15 vs. 8%,
= 0.032). In elective procedures, the 20-year mortality rate (49% vs. 30%,
< 0.001) was significantly higher in females, especially those under 60 years (OR of 3.158 [1.2-8.6],
= 0.024). Mortality rates up to one year were comparable. Five-year mortality rate (26% vs. 16%,
= 0.027) was higher. Females had longer ventilation times (32% vs. 15%,
< 0.001) and intensive care unit stays (2 vs. 1 days,
= 0.005). For acute procedures, morbidity and mortality rates were comparable between sexes.
Females under 60, undergoing elective ascending aortic surgery showed higher long-term all-cause mortality rates. Implementing sex-specific management strategies and extended follow-up could be essential for improving outcomes in this group.]]></abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>39518452</pmid><doi>10.3390/jcm13216313</doi><orcidid>https://orcid.org/0000-0001-5754-1850</orcidid><orcidid>https://orcid.org/0009-0003-3543-1230</orcidid><orcidid>https://orcid.org/0000-0002-4297-495X</orcidid><orcidid>https://orcid.org/0009-0000-2357-6342</orcidid><orcidid>https://orcid.org/0000-0002-9322-4577</orcidid><orcidid>https://orcid.org/0009-0009-9378-4812</orcidid><orcidid>https://orcid.org/0000-0002-6609-5888</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MDPI - Multidisciplinary Digital Publishing Institute; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access |
| subjects | Angioplasty Body mass index Cardiac arrhythmia Chronic obstructive pulmonary disease Coronary vessels Elective surgery Females Gender differences Heart Hemoglobin Hospitals Intensive care Males Mortality Patients Quality control Sexes Statistical analysis Surgeons Surgery Surgical outcomes Surgical techniques Transient ischemic attack |
| title | Sex Differences in Outcomes After Elective and Acute Aortic Surgery-A Single-Centre Experience over the Last Two Decades |
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