{"id":19600,"date":"2024-04-20T10:36:11","date_gmt":"2024-04-20T14:36:11","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=19600"},"modified":"2024-04-30T13:31:09","modified_gmt":"2024-04-30T17:31:09","slug":"days-alive-and-out-of-hospital","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/days-alive-and-out-of-hospital\/","title":{"rendered":"Days alive and out of hospital for adult female and male cardiac surgery patients: a population-based cohort study"},"content":{"rendered":"<p><strong>Background<\/strong> &mdash; Research shows women experience higher mortality than men after cardiac surgery but information on sex-differences during postoperative recovery is limited. Days alive and out of hospital (DAH) combines death, readmission and length of stay, and may better quantify sex-differences during recovery. This main objective is to evaluate (i) how DAH at 30-days varies between sex and surgical procedure, (ii) DAH responsiveness to patient and surgical complexity, and (iii) longer-term prognostic value of DAH.<\/p>\n<p><strong>Methods<\/strong> &mdash; We evaluated 111,430 patients (26% female) who underwent one of three types of cardiac surgery (isolated coronary artery bypass [CABG], isolated non-CABG, combination procedures) between 2009 \u2013 2019. Primary outcome was DAH at 30 days (DAH<sub>30<\/sub>), secondary outcomes were DAH at 90 days (DAH<sub>90<\/sub>) and 180 days (DAH<sub>180<\/sub>). Data were stratified by sex and surgical group. Unadjusted and risk-adjusted analyses were conducted to determine the association of DAH with patient-, surgery-, and hospital-level characteristics. Patients were divided into two groups (below and above the 10th percentile) based on the number of days at DAH<sub>30<\/sub>. Proportion of patients below the 10th percentile at DAH<sub>30<\/sub> that remained in this group at DAH<sub>90<\/sub> and DAH<sub>180<\/sub> were determined.<\/p>\n<p><strong>Results<\/strong> &mdash; DAH<sub>30<\/sub> were lower for women compared to men (22 vs. 23 days), and seen across all surgical groups (isolated CABG 23 vs. 24, isolated non-CABG 22 vs. 23, combined surgeries 19 vs. 21 days). Clinical risk factors including multimorbidity, socioeconomic status and surgical complexity were associated with lower DAH<sub>30<\/sub> values, but women showed lower values of DAH<sub>30<\/sub> compared to men for many factors. Among patients in the lowest 10th percentile at DAH<sub>30<\/sub>, 80% of both females and males remained in the lowest 10th percentile at 90 days, while 72% of females and 76% males remained in that percentile at 180 days.<\/p>\n<p><strong>Conclusion<\/strong> &mdash; DAH is a responsive outcome to differences in patient and surgical risk factors. Further research is needed to identify new care pathways to reduce disparities in outcomes between male and female patients.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &mdash; Research shows women experience higher mortality than men after cardiac surgery but information on sex-differences during postoperative recovery is limited. Days alive and out of hospital (DAH) combines death, readmission and length of stay, and may better quantify sex-differences during recovery. This main objective is to evaluate (i) how DAH at 30-days varies [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[24,40,25,21],"migration-helper-qa-sample-set":[],"class_list":["post-19600","journal_article","type-journal_article","status-publish","hentry","topic-acute-and-emergency-services","topic-cardiovascular-disease","topic-surgery","topic-women-or-gender-based-research"],"acf":{"citation":"Jerath A, Wallis CJD, Fremes S, Rao V, Yau TM, Heybati K, Lee DS, Wijeysundera HC, Sutherland J, Austin PC, Wijeysundera DN, Ko DT. <em>BMC Cardiovasc Disord<\/em>. 2024; 24(1):215. Epub 2024 Apr 20.","source_url":"https:\/\/doi.org\/10.1186\/s12872-024-03862-7","ices_scientist":[1277,1290,1133,1385,1132,1146],"site":[6733],"research_program":[6742],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Days alive and out of hospital for adult female and male cardiac surgery patients: a population-based cohort study<\/title>\n<meta name=\"description\" content=\"Background &mdash; Research shows women experience higher mortality than men after cardiac surgery but information on sex-differences during postoperative\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/days-alive-and-out-of-hospital\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Days alive and out of hospital for adult female and male cardiac surgery patients: a population-based cohort study\" \/>\n<meta property=\"og:description\" content=\"Background &mdash; 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