Are the Early Postoperative Outcomes of Coronary Artery Bypass Grafting Surgery in Elderly Women Worse Compared to Men's?

Abstract Objective: To investigate the impact of gender difference in early postoperative outcomes in elderly patients (aged 70 or older) undergoing coronary artery bypass grafting surgery. Methods: Between October 2009 and December 2013, a total of 223 elderly patients (aged 70 or older) undergoing isolated primary coronary artery bypass grafting surgery were included in this retrospective observational cohort study. Patients were divided into two groups according to their gender. The patients' medical records were collected, their baseline preoperative characteristics, operative data, and postoperative outcomes were retrospectively reviewed, and the effect of gender difference in the early postoperative outcomes was analyzed. Results: Group 1 (female patients) and Group 2 (male patients) consisted of 71 and 152 patients, respectively. Mean age of patients was 74.4±3.6 years (range: 70-84 years). The level of EuroSCORE I, the incidence of hypertension and hyperlipidemia were significantly higher in Group 1, while the rate of smoking was significantly higher in Group 2. Mean postoperative intubation time, length of intensive care unit and hospital stay were longer in female patients than in male patients, but these differences were not statistically significant. No statistically significant difference between two groups in terms of the transfusion of blood products was observed. The rates of in-hospital mortality and major postoperative complications were statistically similar between the two groups. Conclusion: In conclusion, the female gender was not associated with worse early postoperative outcomes in elderly patients undergoing coronary artery bypass grafting surgery.

摘要 研究目的：探讨性别差异对70岁及以上老年患者行冠状动脉旁路移植术（coronary artery bypass grafting）后早期临床结局的影响。
研究方法：本回顾性观察队列研究纳入2009年10月至2013年12月期间接受单纯原发性冠状动脉旁路移植术的223例70岁及以上老年患者。按照性别将患者分为两组，收集患者病历资料，回顾性分析其术前基线特征、手术相关数据及术后结局，并分析性别差异对术后早期临床结局的影响。
研究结果：第1组（女性患者）与第2组（男性患者）分别纳入71例和152例患者。患者平均年龄为74.4±3.6岁（范围：70~84岁）。第1组患者的欧洲心脏手术风险评估系统I（EuroSCORE I）评分、高血压及高脂血症患病率显著高于第2组，而第2组患者的吸烟率显著更高。女性患者的术后平均气管插管时间、重症监护病房（intensive care unit）停留时长及住院时长均长于男性患者，但上述差异无统计学意义。两组患者的血液制品输注率无统计学差异。两组患者的住院死亡率及术后主要并发症发生率均无统计学显著性差异。
研究结论：综上，在接受冠状动脉旁路移植术的老年患者中，女性性别与较差的术后早期临床结局并无关联。