- The Washington Times - Tuesday, February 28, 2006

Higher rates of infection in women undergoing heart-bypass surgery may be a major reason why they face up to twice the risk of death compared with men in the first months after the procedure, according to a new study.

Researchers at the University of Michigan Health System in Ann Arbor calculated that as much as 96 percent of the sex difference in the death risk may be explained by differences in infection rates.

“We found that 16 percent of women patients had an infection, compared with 10 percent of men,” said Mary A.M. Rogers, lead author of the study published Monday in the Archives of Internal Medicine. She is research director of the Patient Safety Enhancement Program at the University of Michigan and the Veterans Affairs Ann Arbor Healthcare Center.

The difference held true even when other factors such as age, race, urgency of the operation, length of hospital stay and most co-existing medical conditions were taken into account.

“We suspect that there may be a systemic, or bodywide, response to infection, making infection at any site a concern for elderly patients,” said Miss Rogers, noting that women were more likely than men to have infections of the urinary, respiratory and digestive tracts, as well as skin and postoperative infections.

Doctors and researchers have known for some time that women often fare worse after bypass surgery, and the discrepancy has been attributed to a number of other problems — women are usually smaller and older and have more unrelated health problems than men undergoing the procedures, to name some examples. Even the physical changes behind narrowed and blocked arteries tend to be different in men and women.

The new study adds another contributing factor, based on the review of more than 9,200 Michigan Medicare patients who had bypass surgery over 15 months. But the report also raises more questions.

Although the study found that women who had heart surgery were more likely to have an infection than male counterparts, women were less likely to die from an infection than male patients.

“This finding was surprising since, overall, women had greater mortality,” Miss Rogers said. “But when we looked closer, we found there were two underlying relationships: a greater prevalence of infection in women, and higher mortality, once infected, among men.”

Men who had an infection were three times more likely to die within 100 days than men who did not have an infection during recovery; women with infections were 1.8 times more likely to succumb than women who did not have an infection.

Such patterns have long been noted in elderly populations, the researchers said.


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