Background. Women experience greater complications and early mortality after both percutaneous interventions and coronary bypass surgery (CABG). Coronary artery disease is becoming more prevalent among women. The aim of the study was to determine whether gender differences in outcomes of surgical treatment persist at our institution.
Methods. A retrospective review of 3177 consecutive CABG patients operated on at our institution during a five-year period. A number of demographic and preoperative risk factors were analyzed to evaluate the risk of surgical procedure. Intraoperative variables reflected the surgical and anesthetic management of the patients. Mortality was the primary outcome, but major morbidity was also analyzed. Logistic regression analysis was performed to identify the independent predictors of postoperative mortality.
Results. The observed crude mortality rate was higher in women than in men (5.2% vs 2.8%, p < 0.05). Women were older (67.5 ± 8.3 vs 63.1 ± 9.4 years, p < 0.001) and had a greater incidence of comorbidities. The internal thoracic artery as a conduit was used with a lower rate in female patients (62.5% vs 77.8%, p < 0.01). Women had a higher rate of low cardiac output syndrome, were less likely to be extubated early following the procedure and required a higher rate of blood transfusions (45.2% vs 25.4%, p < 0.01). Logistic regression analysis revealed that age, left ventricle ejection fraction and female gender were significant independent predictors of postoperative mortality.
Conclusion. Despite advances in surgical and anesthetic techniques, female patients are operated on with an almost twice as high mortality rate as men. The risk profile of female patients differs greatly from male patients. These factors could have a negative impact on the results of surgical treatment of women.

Keywords: risk assessment, mortality, gender, coronary bypass surgery