Introduction
Female sex is reported as a risk factor for mortality and morbidity
during and after cardiac surgery (1). Whilst advancements in technology
and peri-operative care have improved cardiac surgery mortality overall,
risk prediction models such as Society of Thoracic Surgeons and
Euroscore II, still confer additional operative risk to female patients
(2).
Many explanations for this increased peri-operative risk have been
postulated. Firstly, women tend to present later in their disease
process and have poorer pre-operative baseline risk profiles than males
(3). Secondly, female anatomy is reported to be operatively more
challenging with smaller, tortuous coronary arteries and smaller
diameter cardiac valves (4,5).
A meta-analysis previously published by our group showed females were at
a higher risk of mortality and post-operative stroke than males
following cardiac surgery (6). However, findings from observational
national datasets are conflicting with some studies reporting an
increased mortality risk for females (7-9) whilst others report no
sex-related differences in mortality following cardiac surgery (10-12).
To date, there has not been a sex-specific analysis of contemporary
practice of a national outcome dataset from the UK.
The aim of this study was to determine the differences in outcomes
between females and males after coronary revascularisation and valvular
cardiac surgery within the UK’s current practice. The primary outcome
was short-term (30-day) mortality. Secondary outcomes included
short-term complications such as stroke, sternal wound infection,
re-operation for bleeding and length of hospital stay.