Cardiothoracic & vascular anaesthesia
Sex-specific differences in the standard of care for infrarenal abdominal aortic aneurysm repair, and risk of major adverse cardiovascular events and death
Main finding · MACEDResult — go to the resultRisk-adjusted OR 1.33 95 per cent CI 1.12–1.59Authors' conclusion
SOC waiting times and preoperative assessment were not met for both sexes, which was associated with an increased risk of MACED. Sex-specific differences in SOC attenuated but did not fully account for the increased risk of MACED in women.
Study context
- Population
- Patients undergoing elective infrarenal abdominal aortic aneurysm repair, 2013–2020
- Participants
- 21,810 patients
- Exposure
- Women vs men
- Womenn = 2,380
- Menn = 19,430reference
- Outcome
- Major cardiovascular event and/or death (MACED)
Methodological detailsnational registry (National Vascular Registry), risk-adjusted
- National registry (National Vascular Registry)
- Risk-adjusted
Main finding
MACED
Risk-adjusted OR
1.33
95 per cent CI 1.12–1.59
By group
Women
12.0 per cent
Men
8.9 per cent
As reported in the abstract
Observational data: associations, not effects.
Further findings
Repair within SOC waiting times
P < 0.001
Preoperative assessment (multidisciplinary/anaesthetic review)
P = 0.742
Secondary prevention for known cardiac disease
P = 0.015
Overall cardiovascular risk prevention standards met
P < 0.001
MACED by standard of care (SOC) met (all patients)
| OR (CI) | ||
|---|---|---|
| SOC preoperative assessment | 0.86 (0.75–0.98) | |
| SOC waiting times | 0.78 (0.69–0.87) | |
| 0.512Odds ratio (log scale) |
| Outcome | OR (CI) | |
|---|---|---|
| MACED by SOC preoperative assessment, by sex (subgroup)Women vs Men | 0.69 (0.50–0.97) | |
| MACED by SOC waiting times, by sex (subgroup)Women vs Men | 0.84 (0.62–1.16) | |
| 0.512Odds ratio (log scale) |
MACED by SOC preoperative assessment, by sex (subgroup)
| OR (CI) | ||
|---|---|---|
| Men | 0.89 (0.77–1.03) | |
| 0.512Odds ratio (log scale) |
MACED by SOC waiting times, by sex (subgroup)
| OR (CI) | ||
|---|---|---|
| Men | 0.76 (0.67–0.87) | |
| 0.512Odds ratio (log scale) |
- MACED by SOC preoperative assessment, by sex (subgroup): interaction P = 0.170
- MACED by SOC waiting times, by sex (subgroup): interaction P = 0.570
Original publication
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