Sex Differences in Procedure Selection and Outcomes of Patients Undergoing Mitral Valve Surgery
| Autor: | Lacey M. Stelle, Theresa M. Boley, Christina M. Vassileva, Steve Markwell, Stephen R. Hazelrigg |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Statistics as Topic Heart Valve Diseases Postoperative Complications Sex Factors Risk Factors Mitral valve Confidence Intervals Odds Ratio medicine Health Status Indicators Humans Propensity Score Aged Mitral valve repair business.industry valvular heart disease Age Factors Odds ratio Middle Aged medicine.disease Confidence interval Surgery Treatment Outcome medicine.anatomical_structure Concomitant Propensity score matching Mitral Valve Female Cardiology and Cardiovascular Medicine business Mitral valve surgery |
| Zdroj: | The Heart Surgery Forum. 14:276 |
| ISSN: | 1522-6662 1098-3511 |
| DOI: | 10.1532/hsf98.20111030 |
| Popis: | Background: There is a paucity of data on sex differences in procedure selection and outcomes of patients undergoing mitral valve surgery.Methods and Results: The National Inpatient Sample database from 2005 to 2008 was searched to identify patients ?30 years of age who underwent mitral valve repair or replacement (ICD-9-CM codes 35.12, 35.23, and 35.24). Women constituted 51.6% of the patients, and they were older, were less affluent, had higher values for the Charlson comorbidity index, and more often presented on an urgent/emergent basis. Women underwent repair less often than men (37.9% versus 55.9%, P < .001) and more often underwent concomitant tricuspid surgery or a Maze procedure. After adjustment for propensity scores, women were more likely to undergo replacement (odds ratio, 1.78; 95% confidence interval, 1.64-1.93; P = .0001), they had longer lengths of stay, and less favorable disposition. Among the patients who underwent mitral valve repair, women had a higher hospital mortality (2.06% versus 1.36%, P = .0328). After adjustment for propensity scores and concomitant procedures, this relationship was no longer statistically significant.Conclusions: Women are less likely than men to receive mitral valve repair. Although the higher hospital mortality of women presenting for mitral valve surgery was accounted for by their worse preoperative profiles, this sex disparity reflects the current reality in surgical practice and identifies an important area for future improvement in the care of patients with valvular heart disease. |
| Databáze: | OpenAIRE |
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