Women are more likely to die from a post-operative complication after undergoing heart surgery than men, according to a new study.
- Men and women had a similar rate of complications after surgery. It is around 15%.
- On the other hand, women are more likely to die from it than men.
- This could, among other things, be linked to later management of complications.
Although the complication rate after heart surgery is similar in men and women, women have a greater risk of dying from a complication. After highlighting this phenomenon, researchers at the University of Michigan put forward several hypotheses that could explain it.
Their work was published in the journal JAMA SurgeryOctober 16, 2024.
Heart surgery: more women die from complications
To get a better picture of operative risks after cardiovascular surgery, scientists studied the records of more than 850,000 patients who underwent high-risk heart surgery – including heart bypass surgery, aortic aneurysm repair and mitral and aortic valve repair – between 2015 and 2020.
Analyzes showed that men and women had a similar rate of complications after surgery. It is around 15%. The most common disorders for both sexes were kidney failure, pneumonia and lung failure.
On the other hand, more patients died from these complications within 30 days. In fact, surgical teams failed to save them 10.7% of the time. For comparison, the rate was 8.6% among men.
Postoperative complication: women identified later than men?
Why do women die more from complications after heart surgery if they have a similar rate of postoperative disorders to men? Co-author Dr Gorav Ailawadi puts forward a hypothesis in a press release : “In our study, female patients had a lower rate of reoperation (a second operation in the days following the first, Editor’s note) than men, explains the expert. This may not be due to a reduced need for reoperation: rather, it could be a sign that their complications were not treated appropriately.”
Other factors also complicate care: women are on average older when they have surgery and have more comorbidities than men. In addition, their anatomy and the size of their vessels are smaller. This can make the surgery more technically difficult. Additionally, it should be remembered that previous research has shown that symptoms of common cardiovascular disease, such as heart attack and stroke, are more often either missed or taken less seriously by female patients.
For co-author Dr Andrew Ibrahim, the results of this study offer essential information to improve the care of women. “In addition to reducing complications overall, we need to focus on what happens after a complication occurs. Likewise, we have an opportunity after surgery to improve early recognition when a patient has a complication before her condition worsens to the point where we cannot save her Improving recognition and response to postoperative complications, particularly for women, is needed to reduce long-standing disparities in. results after high-risk surgery.”
Dr. Catherine M. Wagner, first author, adds that further research on gender differences in healthcare is needed to “addressing the long-standing neglect of women’s health and identifying the underlying mechanisms that, if addressed, can improve outcomes for all patients”.
