Молодежный инновационный вестник

2415-7805

Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации

10277

Conference Proceedings

Comparative analysis of some health indicators of patients of different sexes when planning coronary artery bypass grafting.

Ulyanov

Ignatiy Andreevich

ilyanov.ignat@yandex.ruhttps://orcid.org/0000-0003-1414-5406Ostroushko

Nadezhda Igorevna

Candidate of Medical Sciences, Associate Professor of the Department of Management in Healthcaren.i.ostroushko@vrngmu.ruhttps://orcid.org/0000-0002-2667-4180

Voronezh State Medical University named after N.N. Burdenko

25042025

14S1655657

19022025

28022025

2025

Introduction. The gender of the patient plays an important role in the treatment of many pathologies. Diseases of the circulatory system are no exception. The gender of the patient is also important when choosing the tactics of surgical treatment of coronary heart disease (CHD). This will be discussed in the presented paper. Goal. To compare some health indicators of patients of different genders when planning coronary artery bypass grafting. Materials and methods. To fulfill the purpose of the work, retrospective anonymized data was collected from the medical records of 408 patients who underwent coronary artery bypass surgery in 2024. The base for surgical intervention, treatment and subsequent information collection was the Cardiac Surgery Department No. 2 of the Voronezh Regional Clinical Hospital No. 1. Statistical processing of the material was carried out in the SPSS Statistics 23 program using a nonparametric criterion for two independent samples of Mann-Whitney U. Results. During the year of the department's operation, 318 men and 90 women underwent surgery. The probability of death on the resulting scale after surgery among men is 26.2% lower than among women and amounted to 1.47% for men and 1.91% for women. Among men who underwent coronary artery bypass grafting, the fact of a heart attack was found in 56% (179 people), and among women in 64% (58 people). The time elapsed from a heart attack to surgery was 1111 days for men and 602 days for women. The average number of bed days was 14.52 for men and 16 for women. Thus, the women were treated by 10.2% more (the differences were statistically significant at p0.001). Conclusion. Based on the results obtained during the study, it can be concluded that the number of men in need of coronary artery bypass grafting is significantly higher than that of women, but the perioperative risks in women are higher. This requires careful consideration of the choice of methods and volumes of surgical treatment of coronary artery disease in women.

diseases of the circulatory systemcoronary artery diseasecoronary artery bypass graftingmanwoman.

болезни системы кровообращенияишемическая болезнь сердцааортокоронарное шунтированиемужчинаженщина.

Introduction. The gender of the patient plays an important role in the treatment of many pathologies. Diseases of the circulatory system are no exception. It is believed that men have a higher risk of fatal cardiovascular events when calculated on the SCORE 2 scale, and women increase the likelihood of thromboembolic complications with atrial fibrillation or flutter (CHA2DS2-VASc scale).[1-3] The gender of the patient is also important when choosing the tactics of surgical treatment of coronary heart disease.[4] This will be discussed in the presented paper. The aim of the work is a comparative analysis of some indicators of patients of different sexes when planning coronary artery bypass grafting (CABG). Materials and methods of research. To fulfill the purpose of the work, retrospective anonymized data was collected from the medical records of 408 patients who underwent coronary artery bypass surgery in 2024. The base for surgical intervention, treatment and subsequent information collection was the Cardiac Surgery Department No. 2 of the Voronezh Regional Clinical Hospital No. 1. Statistical processing of the material was carried out in the SPSS Statistics 23 program using a nonparametric criterion for two independent samples of Mann-Whitney U. Because the samples did not have a normal distribution and the variance of the compared groups was not equal. The results of the study. A significant gender imbalance was revealed during the formation of the groups. During the year of the department's operation, 318 men and 90 women underwent surgery. This difference did not arise as a result of selection, since all patients who underwent isolated coronary artery bypass surgery for a year were taken for analysis. The predominance of men is an established trend for many cardiac surgical hospitals. Further, the probability of death during surgery was calculated for each patient according to the EuroSCORE II scale. [5]This is the only internationally recognized scale that allows a comprehensive assessment of the severity of a patient's condition before heart surgery. It takes into account many parameters, including age, gender, previous heart attacks and strokes, chronic kidney disease, ejection fraction, insulin-dependent diabetes mellitus, and many others.[6] As a result, the probability of death after surgery among men is 26.2% lower than among women and amounted to 1.47% for men and 1.91% for women. The differences were statistically significant at p0.001. However, it is worth noting that the gender criterion is also included in the EuroSCORE II assessment criteria and its weight for women is 0.2196434 primary points, as opposed to 0 points for men. Therefore, in order to compare gender characteristics in the planning of coronary artery bypass grafting, an assessment of other independent criteria was carried out. One of these criteria was the patient's age. For men, the average age of CABG was 63.78 years, and for women 66.14. Age differences between men and women are also statistically significant at p0.05. It is generally accepted that the higher the age of the patient, the more difficult it is for him to undergo surgery on the heart. Another important criterion is the fact of a previous heart attack. Among men who underwent coronary artery bypass grafting, the fact of a heart attack was found in 56% (179 people), and among women in 64% (58 people). The time elapsed from a heart attack to surgery was 1111 days for men and 602 days for women. This indicates that female patients were more likely to suffer a myocardial infarction and it was closer to the time of surgery. Both of these factors negatively affect the surgical prognosis. Another indicator that was analyzed in this paper is the number of days spent in the hospital. This criterion may indirectly indicate the severity of the postoperative period, since if various complications of surgery or concomitant diseases occur, the patient stays in the hospital for a longer time. The average number of bed days was 14.52 for men and 16 for women. Thus, the women were treated by 10.2% more (the differences were statistically significant at p0.001). To obtain complete information about gender differences in CABG planning, other parameters will be analyzed in subsequent studies. But the work done is already enough to form some conclusions. Conclusion. Based on the results obtained during the study, it can be concluded that the number of men in need of coronary artery bypass grafting is significantly higher than that of women, but the perioperative risks in women are higher.

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2. Поляков, И. А. Возрастные и половые особенности коморбидности различных форм ишемической болезни сердца и сахарного диабета второго типа / И. А. Поляков // Молодежная наука и современность : Материалы 89 Международной научной конференции студентов и молодых ученых, посвященной 89-летию КГМУ: в 2-х томах, Курск, 25–26 апреля 2024 года. – Курск: Курский государственный медицинский университет, 2024. – С. 218. – EDN UHIOWV.

3. Острый коронарный синдром у женщин. Есть ли особенности? / Т. О. Бродовская, Э. В. Аребьев, И. Ф. Гришина, М. И. Петровских // Уральский медицинский журнал. – 2023. – Т. 22, № 4. – С. 128-139. – DOI 10.52420/2071-5943-2023-22-4-128-139. – EDN PKKYBD.

4. Коморбидность ишемической болезни сердца и еe значение в прогнозировании результатов аортокоронарного шунтирования / В. Ю. Рублев, Б. И. Гельцер, Е. А. Сергеев [и др.] // Бюллетень сибирской медицины. – 2022. – Т. 21, № 1. – С. 152-161. – DOI 10.20538/1682-0363-2022-1-152-161. – EDN BABQSB.

5. Parajuli, S. Sh. Comparison of Logistic Euroscore with Euroscore II in predicting postoperative mortality in adult cardiac surgical patients / S. Sh. Parajuli, N. Rajbhandari, A. Thakur // Nepalese Heart Journal. – 2022. – Vol. 19, No. 1. – P. 7-9. – DOI 10.3126/njh.v19i1.45275. – EDN DWAZSU.