Increased Mortality in Women Following CABG
Rogers MAM, Langa KM, Kim C, et al. Contribution of infection to increased mortality in women after cardiac surgery. Arch Intern Med. 2006; 166: 437-443.
The authors conducted a cohort study of 9,218 Michigan Medicare beneficiaries hospitalized for coronary artery bypass graft (CABG) surgery. Women hospitalized for CABG surgery were more likely to have an infection than men (16.1% vs 9.8%, P < .001), regardless of age, race, type of admission, hospital volume, or presence of comorbidities. Infections of the respiratory tract, urinary tract, digestive tract, and skin and subcutaneous tissue were more common in women than in men. The risk of death in men increased threefold with infection, whereas the risk in women increased 1.8-fold. The interaction between infection and sex on mortality was significant after adjusting for age, type of admission, and presence of comorbidities (P = .008). The unadjusted percentage of deaths attributable to female sex was 13.9%, which decreased to 0.3% when adjusted for infection. Of the excess deaths in women, 96% could be accounted for by the differential distribution of infection between the sexes. The increased risk of mortality after CABG surgery in women may be explained by underlying differences in the prevalence of infection among men and women.