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. 2021 Jan;49(1):300060520985295.
doi: 10.1177/0300060520985295.

Differences in perioperative cardiovascular outcomes in elderly male and female patients undergoing intra-abdominal surgery: a retrospective cohort study

Song-Yun Chu  1 , Pei-Wen Li  2 , Xiao-Ning Han  1 , Lin Liu  1 , Xiao-Jin Ye  1 , Jie Wang  1 , Jing Zhao  1 , Wen-Hui Ding  3
Affiliations

Differences in perioperative cardiovascular outcomes in elderly male and female patients undergoing intra-abdominal surgery: a retrospective cohort study

Song-Yun Chu et al. J Int Med Res. 2021 Jan.

Abstract

Objective: Perioperative cardiovascular events constitute the majority of complications in noncardiac surgery. Older and female patients have been less investigated. We aimed to evaluate differences in perioperative cardiovascular outcomes by age and sex.

Methods: We enrolled 1079 patients (57.5 ± 17.0 years, 42.6% women) undergoing intra-abdominal surgery from July 2007 to June 2008 and compared occurrence of perioperative cardiac events by age (≥65 vs. <65 years) and sex. Multivariable logistic regression was used to investigate associations between age, sex, and outcomes.

Results: Age ≥65 years was associated with perioperative myocardial infarction (MI) (odds ratio [OR] 2.9, 95% confidence interval [CI]: 1.3-6.6) and total cardiovascular events (OR 2.4, 95% CI: 1.3-4.2). Age ≥65 years was associated with higher perioperative MI risks in men (OR 4.7, 95% CI: 1.3-17.6) than in women (OR 3.1, 95% CI: 1.2-8.3). Advanced age was associated with heart failure in women (OR 13.9, 95% CI: 1.7-110.5). Female sex was a risk factor for heart failure in elderly patients (OR 4.2, 95% CI: 1.1-15.7).

Conclusions: Advanced age appeared to be associated with increased perioperative cardiac risk but differed by sex. Tailored strategies should be considered with respect to the patient's sex.

Keywords: Age; cardiovascular outcome; myocardial infarction; perioperative; sex; surgery.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Occurrence of perioperative cardiovascular events in older (≥65 years) and younger (<65 years) patients in the whole population (a) and in male (b) and female (c) subgroups.
Figure 2.
Figure 2.
Forest plot showing the association between advanced age (≥65 years) and the adjusted odds ratio (OR) of perioperative cardiovascular outcomes. Horizontal lines represent 95% confidence intervals (CI). *p < 0.05.
Figure 3.
Figure 3.
Perioperative cardiovascular events occurred in male and female patients in the whole population (a) and in the younger (<65 years) (b) and older (≥65 years) (c) subgroups.
Figure 4.
Figure 4.
Forest plot showing the association between female sex and adjusted odds ratio (OR) of perioperative cardiovascular outcomes in older patients (≥65 years). Horizontal lines represent 95% confidence intervals (CI). *p < 0.05.
See this image and copyright information in PMC

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