The literature on gender bias in PTCA is mixed. Several older studies suggest significant differences in care; later studies suggest recent technological advances may obviate these differences. However, these later studies also exhibit assorted and sometimes contrary findings. We sought to examine recent administrative data to determine the effect, if any, of gender on outcomes in PTCA.
Data on 7,413 consecutive single or multiple vessel interventions were obtained from a decision support system (DSS) from cardiac surgical hospitals in one the largest healthcare systems in the US, Trinity Health, from 2000 and 2001. Outcome measures studied were differences in severity adjusted: LOS (length of stay), mortality, total hospital cost and departmental costs, prevalence of complications, diagnostic testing, and readmissions within 31 days of discharge. Parametric and non-parametric tests were used to compare 4,838 males vs. 2,575 females.
Significantly higher readmission rates, complication rates and LOS were found in women. They also had higher severity adjusted ICU and Lab costs while their overall adjusted costs were lower. Although older but presenting with significantly less AMI, they exhibited significantly higher severity adjusted in-hospital mortality. No differences were found in thrombolytic agents, diagnostic testing or vessel disease. Additional drilldowns may elucidate why females appear to have such higher severity adjusted rates.CONCLUSIONS: We used DSS data to study multi-hospital PTCA interventions. We found that significant gender differences are present in PTCA outcomes. Essentially, females experience greater rates of complications, readmissions and mortality than males. Further investigation using 2002 data as a cohort and these data as a control is planned to determine if these findings persist.
It is now appreciated that gender has a significant impact on the outcome of treatment for coronary artery disease, although the specifics are only now coming to light.
F. Piontek, None.