Abstract 17509: Gender-Specific Differences in Patients Undergoing Coronary Artery Bypass Grafting

Abstract

Background: Several studies suggested that females undergoing coronary artery bypass grafting (CABG) have poorer outcomes than males. However, we noted contradicting findings regarding short and long-term mortalities among females. Our aim is to assess gender-specific differences in pre and post -operative CABG risk factors and outcomes. Methods: Our cohort included 7,687 adult patients who underwent CABG surgery between 2006 and 2022 in a large rural healthcare system. Patients were grouped by gender and continuous variables were summarized using median and inter-quartile range. Appropriate statistical tests were conducted to assess differences. Results: There were 1827 (23.8%) females and 5860 (76.2%) males. Females were slightly older ((68, 60.5, 75) vs (67, 65, 73), p<0.0001), with higher total number of Elixhauser comorbidities ((6, 3, 8) vs (4, 3, 7), p<0.0001), higher cha2ds2vasc scores ((4, 3, 5) vs (3, 2, 4), p<0.0001) and higher prevalence of stroke history (12.4% vs 10.3%, p=0.013). Analysis of risk factors used for computing the Society of Thoracic (STS) scores revealed several significant differences (with p<0.001) between females and males including sleep apnea (12.1% vs 15.7%), diabetes (52.7% vs 43.4%), depression (25.5% vs 13.9%), and BMI ((31.6, 14.4, 35.5) vs (28.8, 25.8, 33.7)). Compared to males, females had greater need for blood transfusions (49.8% vs 33.6%), prolonged post-operative pulmonary ventilation (33.8% vs 24.4%), mediastinal drainage (13.4% vs 6.4%) and more frequent acute cardiac arrests (7.2% vs 4.8%). In addition females had higher 30-day mortality (0.93% vs 0.84%, p=0.014), 1-year mortality (4.2% vs 2.9%, p=0.0003), 1-year incident stroke (2.2% vs 1.5%, p=0.05), longer hospital length of stay (LoS) in hours ((143.4, 116.9, 191.6) vs (120.7, 96.9, 167.2), p<0.0001), ICU LOS in hours ((96, 48.8, 143.9) vs (77.9, 39.4, 120), p<0.0001), and duration from discharge to all-time mortality in days ((1513, 523.5, 2723.5) vs (1740, 622, 2921), p=0.008). Conclusions: Female gender is linked to several pre-operative and post-operative risk factors and are at greater risk of adverse outcomes following CABG surgery. Further work is needed to understand the causes of these discrepancies and to limit their effect on outcomes.