1993 2003 gender differences in coronary artery revascularization: has anything changed?

J Cardiovasc Nurs. 2005 Nov-Dec;20(6):461-7. doi: 10.1097/00005082-200511000-00015.

Abstract

Background: Gender differences abound in patients undergoing coronary artery bypass graft (CABG) surgery. Most research was conducted in the early 1 990s. It is unknown if gender differences have diminished over time.

Research objectives: To determine whether gender differences exist in the current era of CABG surgery by examining preoperative, intraoperative, and postoperative factors known to affect outcomes.

Subjects and methods: In this descriptive, correlational study of all patients undergoing primary, isolated CABG at a large, urban Midwestern healthcare center, data in 1993 and 2003 were analyzed to determine if gender and time differences existed and if there was a time and gender interaction effect. Trained nurses prospectively collected data during the index hospitalization for the institution's Cardiovascular Information Registry.

Results: 2,200 patients were studied; women accounted for one-fourth of the sample. Age over 65 years; current smoking; presence of hypertension, cerebrovascular accident; and insulin-dependent diabetes; symptomatic heart failure and chest pain were significantly associated with female gender (all P' s < .001). Intraoperatively, internal mammary arteries were used less as a graft conduit in women (P < .001); gender differences were most pronounced in patients requiring 2 bypass grafts. Postoperatively, cardiac pump failure and median hospital stay were greater in women (both P' s < .001); however, both decreased over time.

Conclusions: Gender differences continue to exist in patients undergoing CABG. Differences do not affect hospital mortality rates but play a role in hospital length of stay and may affect postdischarge recovery. Research targeted at modifiable preoperative factors may improve postoperative recovery.

Publication types

  • Comparative Study

MeSH terms

  • Coronary Artery Bypass* / mortality
  • Coronary Artery Bypass* / nursing
  • Coronary Artery Bypass* / statistics & numerical data
  • Coronary Artery Bypass* / trends
  • Coronary Disease / diagnosis
  • Coronary Disease / nursing
  • Coronary Disease / physiopathology
  • Coronary Disease / surgery*
  • Female
  • Hospital Mortality
  • Humans
  • Length of Stay
  • Linear Models
  • Logistic Models
  • Midwestern United States / epidemiology
  • Patient Selection
  • Perioperative Care
  • Sex Factors
  • Treatment Outcome