Abstract 13234: Impact of Sex on Outcomes After Cardiac Surgery: A Systematic Review and Meta-Analysis

Abstract

Introduction: Despite advances in cardiac surgery, there is evidence from observational studies which suggests that females have poorer post-operative outcomes than males. This study is the first to review sex related outcomes following both coronary artery bypass graft (CABG) and valve surgery with or without combined CABG. Hypothesis: Females have worse outcomes following cardiac surgery than males. Methods: We identified 30 primary research articles reporting either short-term mortality (in-hospital/30 day), long-term mortality, post-operative stroke, sternal wound infection and post-operative myocardial infarction (MI) in both sexes following CABG and valve surgery with or without combined CABG Reported adjusted odds/hazard ratio were pooled using an inverse variance model. Results: Females were at higher risk of short-term mortality (odds ratio (OR) 1.40; 95% confidence interval (CI) 1.32-1.49; I 2 =79%) and post-operative stroke (OR 1.2; CI 1.07-1.34; I 2 =90%) when compared to males. There was no increased risk in long-term mortality (OR 1.04; 95% CI: 0.93-1.16; I 2 =82%), post-operative MI (OR 1.22; 95%CI: 0.89-1.67; I 2 =60%) or deep sternal wound infection (OR 0.92; 95%CI: 0.65-1.03, I 2 =87%). No evidence of publication bias or small study effect was found. Conclusions: Females are at a greater risk of short-term mortality and post-operative stroke than males following CABG and valve surgery with or without combined CABG. However long-term mortality is equivalent in both sexes.