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• Posted October 16, 2024

When Complications Strike After Heart Surgery, Women More Likely to Die Than Men

Women and men experience similar rates of dangerous complications after a major heart surgery.

So why are women dying at higher rates than men when these complications strike?

That's the main question raised by a new study that involved more than 850,000 cases of Medicare beneficiaries who underwent high-risk heart surgeries.

These operations included heart bypass, aortic aneurysm repairs, and mitral and aortic valve repairs. All were conducted between 2015 and 2020.

About 15% of male and female patients experienced a post-op complication, found a team led by Dr. Catherine Wagner. She's an integrated thoracic surgery resident doctor at University of Michigan Health, in Ann Arbor.

Her team found that while 8.6% of men who experienced these complications died (something doctors call "failure to rescue"), that number rose to 10.7% among women.

The findings were published Oct. 16 in the journal JAMA Surgery.

“This is an issue for the entire United States health care system: we are failing to rescue women after high-risk surgery, even though the rate of postoperative complication is similar to men,” Wagner said in a university news release.

According to the research, the most common post-surgical complications were kidney failure, pneumonia and lung failure.

Failure to rescue rates were higher among female patients versus males, regardless of how high- or low-quality the hospital where the patient received treatment was deemed to be.

In fact, women tended to be seen more often than men at higher-quality centers, the researchers noted.

One clue to the gender disparity in outcomes: "In our study, female patients had a lower rate of re-operation than males,” said study co-author Dr. Gorav Ailawadi.

Re-operation means a second procedure was performed within days of heart surgery because a complication arose.

The lower rate of re-operation among women “may not be due to a lower need for re-operation; it could instead be a signal that their complications were not appropriately addressed," said Ailawadi. He's chair of cardiac surgery at U-M Health and a director of the University of Michigan Health Frankel Cardiovascular Center.

It's possible that complications among female patients do not raise the same alarm bells for physicians as they might among men, the researchers theorized.

“In addition to reducing complications overall, we must focus on what happens after a complication occurs," said study co-author Dr. Andrew Ibrahim.

"We have an opportunity after surgery to improve early recognition when a female patient is having a complication before it cascades to a point where we cannot rescue them," Ibrahim said. He's an associate professor of surgery at U-M Medical School and co-director of the Michigan Medicine Center for Healthcare Outcomes and Policy.

"Improving the recognition and response to postoperative complications, especially for women, is needed to reduce longstanding disparities on outcomes after high-risk surgery," Ibrahim said in a university news release.

More information

Find out more about heart surgery at the American Heart Association.

SOURCE: Michigan Medicine - University of Michigan, news release, Oct. 16, 2024