Do in-hospital outcomes of isolated coronary artery bypass grafting vary between male and female octogenarians?. (30th October 2021)

• Record Type: Journal Article
• Authors: Attia, Rizwan Q; Katumalla, Eve; Cyclewala, Shabnam; Rochon, Melissa; Marczin, Nandor; Raja, Shahzad G
• Is Part Of: Interactive cardiovascular and thoracic surgery. Volume 34:Number 6(2022)
• Page Start: 958
• Page End: 965
• Publication Date: 2021-10-30
• Subjects: Coronary artery bypass grafting -- Gender -- Mortality -- Octogenarians -- Outcome; Chest -- Surgery -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.1
• DOI: 10.1093/icvts/ivab281
• Languages: English
• ISSNs: 1569-9293

Abstract

Abstract: OBJECTIVES: Female gender and advanced age are regarded as independent risk factors for adverse outcomes after isolated coronary artery bypass grafting (CABG). There is paucity of evidence comparing outcomes of CABG between male and female octogenarians. We aimed to analyse in-hospital outcomes of isolated CABG in this cohort. METHODS: All octogenarians that underwent isolated CABG, from January 2000 to October 2017, were included. A retrospective analysis of a prospectively collected cardiac surgery database (PATS; Dendrite Clinical Systems, Oxford, UK) was performed. A propensity score was generated for each patient from a multivariable logistic regression model based on 25 pre-treatment covariates. A total of 156 matching pairs were derived. RESULTS: Five hundred and sixty-seven octogenarians underwent isolated CABG. This included 156 females (mean age 82.1 [SD: 0.9]) and 411 males (mean age 82.4 [SD: 2.1 years]). More males were current smokers ( P = 0.002) with renal impairment ( P = 0.041), chronic obstructive pulmonary disease ( P = 0.048), history of cerebrovascular accident ( P = 0.039) and peripheral vascular disease ( P = 0.027) while more females had New York Heart Association class 4 ( P = 0.02), left ventricular ejection fraction 30–49% ( P = 0.038) and left ventricular ejection fraction <30% ( P = 0.049). On-pump, CABG was performed in 140 males and 52 females ( P = 0.921). There was no difference in in-hospital mortality (5.4% vs 6.4%; P = 0.840), stroke (0.9% vs 1.3%; P = 0.689), need for renal replacement therapy (17.0% vs 13.5%; P = 0.732), pulmonary complications (9.5% vs 8.3%; P = 0.746) and sternal wound infection (2.7% vs 2.6%; P = 0.882). The outcomes were comparable for the propensity-matched cohorts. CONCLUSIONS: No gender difference in outcomes was seen in octogenarians undergoing isolated CABG. Abstract : It is widely recognized that the female gender is associated with increased perioperative mortality and morbidity after coronary artery bypass grafting (CABG) [1, 2].