The Impact of Gender on In-Hospital Mortality and Morbidity After Isolated Aortic Valve Replacement
- 1 October 2006
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Anesthesia & Analgesia
- Vol. 103 (4), 800-808
- https://doi.org/10.1213/01.ane.0000231890.95212.12
Abstract
The objective of our retrospective investigation was to examine the influence of gender on in-hospital mortality and morbidity after isolated aortic valve replacement (AVR). Between January 1993 and June 2002, 2212 patients (782 females, 1430 males) underwent AVR. Propensity matching was used to adjust for numerous differences in baseline characteristics and perioperative variables between groups. Unadjusted in-hospital mortality was higher in females (27 [3.5%] females versus 23 [1.6%] males; P = 0.005). An analysis using 1:1 matching by propensity score did not find a significant difference in in-hospital mortality [OR (95% confidence intervals), 1.0 [0.4, 2.6]; P = 0.99) or overall morbidity (1.4 [0.7, 2.5]; P = 0.29) between groups. Further analyses, including classification of women and men into quintile groups by propensity scores and logistic regression models with propensity score adjustment, found that females were at increased risk for cardiac morbidity [OR (95% CI), 3.4 [1.1, 10.8]; P = 0.038), but not mortality (0.9 [0.3, 2.5]; P = 0.88) nor other morbidities. These results suggest that there is no greater than a 2.5-fold increase in risk for females compared with males undergoing AVR. Female gender, however, may impart increased risk for cardiac morbidity after AVR.Keywords
This publication has 30 references indexed in Scilit:
- Gender and outcomes after coronary artery bypass grafting: a propensity-matched comparisonThe Journal of Thoracic and Cardiovascular Surgery, 2003
- Prosthesis size and long-term survival after aortic valve replacementThe Journal of Thoracic and Cardiovascular Surgery, 2003
- Current determinants of operative mortality in 1400 patients requiring aortic valve replacementThe Annals of Thoracic Surgery, 2003
- Surgery for Aortic Regurgitation in WomenCirculation, 1996
- Aortic valve replacement in patients aged eighty years and older: Early and long-term resultsThe Journal of Thoracic and Cardiovascular Surgery, 1996
- Prognostic Models and the Propensity ScoreInternational Journal of Epidemiology, 1995
- The risk of small St. Jude aortic valve prosthesesThe Annals of Thoracic Surgery, 1994
- Differences between men and women in hospital mortality associated with coronary artery bypass graft surgery. The Northern New England Cardiovascular Disease Study Group.Circulation, 1993
- Stratification of Morbidity and Mortality Outcome by Preoperative Risk Factors in Coronary Artery Bypass PatientsJAMA, 1992
- Coronary artery surgery in women compared with men: Analyses of risks and long-term resultsJournal of the American College of Cardiology, 1983