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Clinical Summary

Does sex influence outcomes following cardiac surgery?

Takeaway

  • Women had a greater risk of short-term mortality and post-operative stroke than men following coronary artery bypass graft (CABG) and valve surgery combined with CABG.
  • No difference was seen in isolated aortic valve replacement (AVR), long-term mortality, post-operative myocardial infarction (MI) and deep sternal wound infection in both sexes.
Why this matters
  • Findings add to the existing published literature on sex differences after cardiac surgery by providing a comprehensive description and quantitative assessment of both short- and long-term mortality after cardiac surgery.

Study design

  • Researchers at the University of Bristol performed a meta-analysis of 30 studies, identified through a literature search across electronic databases.
  • Primary outcomes: short-term mortality, either in-hospital or 30-day mortality.
  • Funding: British Heart Foundation and others.
Key results
  • Women vs men undergoing CABG and combined valve surgery and CABG had an increased risk of (OR; 95% CI):
    • short-term mortality (1.40; 1.32-1.49; I2, 79%); and
    • post-operative stroke (1.20; 1.07-1.34; I2, 90%).
  • No significant differences was seen between women and men in (OR; 95% CI):
    • isolated AVR (1.19; 0.74-1.89);
    • long-term mortality (1.04; 0.93-1.16; I2, 82%);
    • post-operative MI (1.22; 0.89-1.67; I2, 60%); and
    • deep sternal wound infection (0.92; 0.65-1.30; I2, 87%).
Limitations
  • Heterogeneity among studies.

References


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