Abstract

Abstract Introduction Women have previously been found to have longer post-operative stays following coronary artery bypass. However, impact of gender on length of stay following infra-inguinal bypass (IIB) surgery for PAD is unknown. Methods A 3-year single centre retrospective case notes analysis of all people undergoing IIB between 2017-2019. Rutherford stage, graft conduit, urgency of bypass, level of bypass, procedure details, baseline demographics, length of stay (LoS), co-morbidities were collected and univariate associations with LoS were reported. Factors associated with increased LoS on univariate analysis were entered into a multivariate model and reported as hazard ratios (HR). Results :193 IIB outcomes on 176 patients were analysed on: mean(±SD) age 68.9(9.2) years; 135(69.9%) male; 88(45.6%) had DM; 87(45.1%) were current smokers and 107(55.4%) underwent emergency procedures. On univariate analysis, LoS for female patients was significantly longer than for male patients (9.5 [6-21] vs. 7[5-15] days, p=0.016). Other factors associated with increased LoS were emergency vs. elective (13[7-22] vs. 5 [4-9] days, p<0.0001, Rutherford stage (p<0.0001), bypass level (p=0.001) and diabetes (9 [5-21] vs. 7[4-15] days, p=0.017) After multivariate adjustment, female gender (RR 1.56 95% CI: 1.12-2.18) was associated with increased LoS. As was elective bypass (RR 0.50 95% CI:0.36-0.71) and lower Rutherford stage (3 vs. 5: RR 0.32 95% CI: 0.2-0.52) (4 vs 5:0.46 95% CI: 0.31-0.68). Conclusion We have demonstrated that female gender is independently associated with significantly longer hospital stays. With further investigation into causation, this could potentially inform pre- and post-operative management to reduce risks to women undergoing IIB.

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