IS THERE DETRIMENTAL GENDER BIAS IN PREOPERATIVE CARDIAC MANAGEMENT OF PATIENTS UNDERGOING VASCULAR-SURGERY

Background To investigate the possibility of gender bias in the cardia c management of patients who undergo peripheral vascular surgery, we e xamined the hospital data and outcomes for 350 adult men and 128 women who underwent vascular surgery from September 1987 to December 1991. Methods and Results There were no significant differences between the two groups in age at operation, incidence of standard risk factors for myocardial infarction, or incidence or duration of episodes of periop erative silent ischemia. Nevertheless, a significantly lower percentag e of women than men had undergone prior coronary bypass procedures (6. 3% and 17.1%, respectively; P<.01), an apparent example of gender bias . However, there was no significant difference in the incidence of per ioperative myocardial infarction in women (3.9%) compared with men (4. 0%). Furthermore, actuarial analysis showed that at 24 months after op eration a significantly higher percentage of women (77.9%) had escaped late cardiac death and cardiac complications than men (71.9%; P<.05). Conclusions These findings indicate that apparent gender bias in the preoperative cardiac management of this group of women who underwent v ascular surgery may have had no detrimental effect on short- and long- term incidence of cardiac death and complications, and may represent s ound clinical judgment rather than true bias. However, the possibility that female patients might have had even better short- and longterm c ardiac results if they had undergone more preoperative cardiac revascu larization cannot be discounted.