Recovery After Bypass Surgery More Difficult for Women

Women have a significantly harder time recovering both physically and mentally from coronary artery bypass graft (CABG) surgery than their male counterparts. These differences cannot be explained by illness severity, presurgery health status or other patient characteristics, according to a study in the January 15th Journal of the American College of Cardiology.

“We know that women have a higher mortality after CABG than men, but there are very little data on how women do in terms of functioning and quality of life and what their own experiences are in the recovery phase,” lead investigator Dr. Viola Vaccarino of Emory University in Atlanta told Reuters Health.

Her team interviewed 804 men and 309 women on admission before CABG surgery and again 6 to 8 weeks after surgery. The subjects included consecutive patient admitted to Yale New Haven Hospital in Connecticut between February 1999 and February 2001 for their first CABG.

Compared with men, women were older and had a lower level of physical and mental function prior to surgery, although they had less atherosclerosis and fewer diseased vessels. However, even after adjusting for these and other baseline characteristics, women tended to have a worse outcome than men.

“Up to about 8 weeks after surgery women, on average, had not recovered and were not doing as well as men,” Dr. Vaccarino said. “Women were basically in worse shape than men in terms of physical functioning and depressive symptoms and they were also complaining of surgery-related side effects much more so than men.”

After CABG, the level of physical and mental functioning among women was lower than it was before the surgery whereas for men it was “pretty much the same or slightly better,” Dr. Vaccarino said.

According to the study, women were almost twice as likely as men to be readmitted to the hospital during the recovery period, 20.5% vs 11.0% (p = 0.005).

Her team concludes that additional studies are needed to elucidate the reasons for the significant gender differences in recovery after CABG surgery.

J Am Coll Cardiol 2003;41:307-314.