Poster No. 028 Sex differences in cardiac operations: Are we being fair to our female patients?. (21st October 2022) - Fitton, Catherine A
Abstract: Introduction: Research suggests that whilst men have a higher cardiovascular disease (CVD) rate, women are more likely to suffer a poor prognosis following CVD, possibly due to incorrect diagnosis and treatments. A question infrequently asked is whether this inequality is due to sex bias when selecting patients for operation. Methods: Patients who had been admitted to hospital with a cardiovascular diagnosis within the Scottish Heart Health Extended Cohort (SHHEC) were studied. Participants were recruited between 1984–1995 and followed up until 2017 via data linkage to NHS hospital records. Using propensity score nearest neighbour matching, admissions for women were matched with men within the cohort on a 1:1 basis. Admissions were matched for common CVD risk factors and generalised logistic mixed models were used to estimate Odds Ratios (OR) and 95% Confidence Intervals (95% CI). Results and conclusions: A total of 25, 318 admissions to hospital for cardiac reasons were recorded over the study period (20, 520 following matching). Women were less likely to have a cardiac procedure (4.57% males, 2.77% females; OR 0.59; 95% CI 0.50–0.70). Women were significantly less likely to have a cardiac operation (2.65% males, 1.47% females; OR 0.55; 95% CI 0.45–0.67), but not endovascular procedures (1.89% males, 1.30% females; OR 0.66; 95% CI 0.37–1.16) following hospital admission. Within the SHHEC cohort, a matched cohort of 20, 520 admissions to hospital over a 30-year period, demonstrated that women were less likely to undergo surgical procedures, even when matched with men on common CVD risk factors.