Female gender: is it dangerous to your health?

Objective: Worldwide most scores for cardiac surgery indicate a higher perioperative risk for female patients. We retrospectively evaluated all patients (age 60–80) from 2003 to 7/2009 in terms of outcomes and perioperative complications to find out, whether there are gender specific differences.

Methods: From 1/03 to 7/09 5998 patients underwent open heart surgery in our department. Patients between 60 and 80 years undergoing eather isolated CABG, isolated AVR, AVR+CABG, MV replacement or MV- repair (n=3570, which is 80% of all patients of that age) were included. We compared preoperative log. Euro-Scores, perioperative complications and outcomes. All data were obtained by HCH-Info, a database for cardiovascular departments.

Results: 2542 male and 1028 female patients between 60 and 80 years were compared. Women were older (mean age 72 vs. 70 years) and had higher preoperative log. Euro-Scores (9.9% vs. 7.8%) Nevertheless ICU-stay (2.6 vs. 2.7 days), in hospital mortality (female: mean 3.3%, mal 3.2%) perioperative complications (e.g. kidney failure, infections, revisions due to bleeding, low cardiac output, long term respiration), and subjective outcomes half a year after operation did not reveal significant differences.

Conclusions: Our data indicate, that the outcomes of women between 60 and 80 years undergoing open heart surgery are as good as the outcomes of men. We think that improved surgical techniques, better myocardial protection, and perfect perioperative ICU treatment lead to these good results. So our data indicate, that female gender is not an additional risk factor in adult heart surgery.