A new study has found that complications following cardiovascular surgery lead to more deaths among women than men, despite similar complication rates in both groups. (Image credit: JohnnyGreig via Getty Images)
A new study has found that women are more likely than men to die from complications after high-risk cardiovascular surgery.
Life-threatening complications such as heart attacks and infections were detected later in women than in men, contributing to higher mortality rates among women. Doctors call the failure to recognize or respond to complications quickly “failure to save.”
The study, published Oct. 16 in the journal JAMA, examined the medical records of more than 860,000 patients who underwent high-risk surgeries from October 2015 to February 2020. All of the procedures involved the heart or blood vessels, including surgeries to repair aneurysms, heart bypasses, and heart valve replacements.
Overall, about 15% of these patients experienced some complications after surgery; similar rates of complications were seen in both men and women. However, among this group, nearly 11% of women died from complications, compared with 8.6% of men. The researchers concluded that this difference was likely due to delays in recognizing and treating complications in women, such as heart attacks, blood clots in the lungs, kidney failure, lung failure, pneumonia, bleeding, and surgical site infections.
Dr. Mario Gaudino, a cardiac surgeon at Weill Cornell Medical Center and New York-Presbyterian Hospital who was not involved in the study, described it as a “wake-up call” about under-researched differences in outcomes between men and women after major surgery.
Notably, women in the study were more likely to receive care at teaching hospitals and large medical institutions than men. These institutions tend to offer higher-quality care than smaller hospitals, but higher mortality rates among women persisted across all types of institutions.
“These findings highlight how widespread this problem is,” said Dr. Katherine Wagner, a cardiac surgery resident at the University of Michigan and lead author of the study. “This suggests a systemic problem that contributes to underrecognition and undertreatment of postoperative complications in women,” Wagner told Live Science in an email.
The study is inconclusive about the factors that may underlie this disparity. Previous studies have focused on the fact that women are more likely to have surgery at an older age than men, which may mean they have more comorbidities and are at a later stage of the disease. These characteristics were also observed in the women in the new study, who were slightly older on average and had slightly higher levels of comorbidities than men.
However, while these factors are important, they do not fully explain the study's findings, which found significantly higher death rates among women despite similar rates and types of complications in men and women, said Dr. Andrei Churila, a cardiac surgeon at Northwestern Medical Group in Chicago who was not involved in the study.
One possible reason, he says, could be unconscious bias against women. Healthcare providers tend to be less sensitive to women’s pain, which can delay or even prevent adequate diagnosis and treatment. A 2022 study published in the Journal of the American Heart Association found that young women complaining of chest pain waited 29% longer to be evaluated for a heart attack than young men, for example.
A lack of understanding of the female heart may also be affecting treatment outcomes, Gaudino suggested. “As cardiologists, I think we’ve had the wrong approach of thinking that women are really like men or just smaller men,” he added. “The mistake we’re making is continuing to apply treatments to women that we know are effective in men.”
According to Gaudino
Sourse: www.livescience.com
