Mais Complicações em Mulheres após Revascularização do Miocárdio Mesmo com Tempos Cirúrgicos Reduzidos: Atenção por Equidade e Melhoria da Qualidade

Mais Complicações em Mulheres após Revascularização do Miocárdio Mesmo com Tempos Cirúrgicos Reduzidos: Atenção por Equidade e Melhoria da Qualidade

Figura Central : Mais Complicações em Mulheres após Revascularização do Miocárdio Mesmo com Tempos Cirúrgicos Reduzidos: Atenção por Equidade e Melhoria da Qualidade

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Published in:Arquivos brasileiros de cardiologia Vol. 121; no. 8
Main Authors: Lacava, Leonardo, de Freitas, Fabiane Letícia, Borgomoni, Gabrielle Barbosa, Silva, Pedro Gabriel Melo de Barros e, Nakazone, Marcelo Arruda, Campagnucci, Valquiria Pelisser, Tiveron, Marcos Gradim, Lisboa, Luiz Augusto, Jatene, Fabio Biscegli, Mejia, Omar Asdrúbal Vilca
Format: Journal Article
Language:English
Published: Sociedade Brasileira de Cardiologia - SBC 01-08-2024
Sociedade Brasileira de Cardiologia (SBC)
Subjects:
Artigo Original
Avaliação de Resultados em Cuidados de Saúde
CARDIAC & CARDIOVASCULAR SYSTEMS
Procedimentos Cirúrgicos Cardiovasculares
Saúde da Mulher
Cardiovascular Surgical Procedures
Saúde da Mulher
Outcome Assessment, Health Care
Avaliação de Resultados em Cuidados de Saúde
Procedimentos Cirúrgicos Cardiovasculares
Women’s Health
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Abstract Figura Central : Mais Complicações em Mulheres após Revascularização do Miocárdio Mesmo com Tempos Cirúrgicos Reduzidos: Atenção por Equidade e Melhoria da Qualidade
AbstractList Resumo Fundamento Análises em grandes registros apontam desfechos desfavoráveis para mulheres submetidas à cirurgia de revascularização do miocárdio (CRM), enquanto estudos randomizados sofrem com a falta de representatividade. Objetivo Comparar os resultados hospitalares ajustados entre homens e mulheres submetidos à CRM. Métodos Entre julho de 2017 e junho de 2019, 3991 pacientes foram submetidos à CRM primária isolada, tanto de forma eletiva como de urgência, em 5 hospitais de estado de São Paulo, Brasil. Para equilibrar as diferenças entre homens e mulheres, as populações foram ajustadas utilizando o Propensity Score Matching. Os desfechos considerados para análise foram os utilizados pelo STS Adult Database. As análises foram conduzidas no software R, considerando significância valores de p < 0,05. Resultados Após o Propensity Score Matching (1:1), cada grupo incluiu 1089 pacientes. Em relação às variáveis intraoperatórias os homens apresentaram maior tempo de CEC (p<0,001), tempo cirúrgico (p<0,001), número de anastomoses distais (p<0,001) e uso de enxertos arteriais. Em relação aos desfechos as mulheres apresentaram maior incidência de infecção de ferida profunda (p=0,006), tempo prolongado na Unidade de Terapia Intensiva (p=0,002), maior necessidade do uso de balão intraórtico (p=0,04), maior taxa de transfusão sanguínea (p<0,001), maior readmissão hospitalar em até 30 dias após a cirurgia (p=0,002) e maior taxa de óbitos (p=0,03). Conclusões Apesar dos homens terem apresentado um maior tempo de CEC, maior número de enxertos arteriais e maior número de anastomoses distais, os resultados imediatos após CRM foram piores em mulheres.
Figura Central : Mais Complicações em Mulheres após Revascularização do Miocárdio Mesmo com Tempos Cirúrgicos Reduzidos: Atenção por Equidade e Melhoria da Qualidade
Author Lacava, Leonardo
Nakazone, Marcelo Arruda
Jatene, Fabio Biscegli
Mejia, Omar Asdrúbal Vilca
Lisboa, Luiz Augusto
Campagnucci, Valquiria Pelisser
Silva, Pedro Gabriel Melo de Barros e
Borgomoni, Gabrielle Barbosa
de Freitas, Fabiane Letícia
Tiveron, Marcos Gradim
AuthorAffiliation 1 Hospital Regional São Paulo Xanxerê SC Brasil Hospital Regional São Paulo, Xanxerê, SC – Brasil
5 Faculdade de Ciências Médicas Santa Casa de São Paulo São Paulo SP Brasil Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP – Brasil
4 Faculdade de Medicina de São José do Rio Preto São José do Rio Preto SP Brasil Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP – Brasil
6 Irmandade da Santa Casa de Misericórdia de Marília Marilia SP Brasil Irmandade da Santa Casa de Misericórdia de Marília, Marilia, SP – Brasil
3 Hospital Samaritano Paulista São Paulo SP Brasil Hospital Samaritano Paulista, São Paulo, SP – Brasil
2 Hospital das Clínicas Faculdade de Medicina Universidade de São Paulo São Paulo Brasil Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP – Brasil
AuthorAffiliation_xml – name: 3 Hospital Samaritano Paulista São Paulo SP Brasil Hospital Samaritano Paulista, São Paulo, SP – Brasil
– name: 2 Hospital das Clínicas Faculdade de Medicina Universidade de São Paulo São Paulo Brasil Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP – Brasil
– name: 4 Faculdade de Medicina de São José do Rio Preto São José do Rio Preto SP Brasil Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP – Brasil
– name: 5 Faculdade de Ciências Médicas Santa Casa de São Paulo São Paulo SP Brasil Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP – Brasil
– name: 1 Hospital Regional São Paulo Xanxerê SC Brasil Hospital Regional São Paulo, Xanxerê, SC – Brasil
– name: 6 Irmandade da Santa Casa de Misericórdia de Marília Marilia SP Brasil Irmandade da Santa Casa de Misericórdia de Marília, Marilia, SP – Brasil
– name: Universidade de São Paulo
– name: Hospital Regional São Paulo
– name: Faculdade de Medicina de São José do Rio Preto
– name: Santa Casa de São Paulo
– name: Hospital Samaritano Paulista
– name: Irmandade da Santa Casa de Misericórdia de Marília
Author_xml – sequence: 1
  givenname: Leonardo
  surname: Lacava
  fullname: Lacava, Leonardo
  organization: Hospital Regional São Paulo Hospital Regional São Paulo, Xanxerê, SC – Brasil Hospital das Clínicas Faculdade de Medicina Universidade de São Paulo Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP – Brasil
– sequence: 2
  givenname: Fabiane Letícia
  surname: de Freitas
  fullname: de Freitas, Fabiane Letícia
  organization: Hospital das Clínicas Faculdade de Medicina Universidade de São Paulo Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP – Brasil
– sequence: 3
  givenname: Gabrielle Barbosa
  surname: Borgomoni
  fullname: Borgomoni, Gabrielle Barbosa
  organization: Hospital das Clínicas Faculdade de Medicina Universidade de São Paulo Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP – Brasil
– sequence: 4
  givenname: Pedro Gabriel Melo de Barros e
  surname: Silva
  fullname: Silva, Pedro Gabriel Melo de Barros e
  organization: Hospital Samaritano Paulista Hospital Samaritano Paulista, São Paulo, SP – Brasil
– sequence: 5
  givenname: Marcelo Arruda
  surname: Nakazone
  fullname: Nakazone, Marcelo Arruda
  organization: Faculdade de Medicina de São José do Rio Preto Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP – Brasil
– sequence: 6
  givenname: Valquiria Pelisser
  surname: Campagnucci
  fullname: Campagnucci, Valquiria Pelisser
  organization: Faculdade de Ciências Médicas Santa Casa de São Paulo Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP – Brasil
– sequence: 7
  givenname: Marcos Gradim
  surname: Tiveron
  fullname: Tiveron, Marcos Gradim
  organization: Irmandade da Santa Casa de Misericórdia de Marília Irmandade da Santa Casa de Misericórdia de Marília, Marilia, SP – Brasil
– sequence: 8
  givenname: Luiz Augusto
  surname: Lisboa
  fullname: Lisboa, Luiz Augusto
  organization: Hospital das Clínicas Faculdade de Medicina Universidade de São Paulo Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP – Brasil
– sequence: 9
  givenname: Fabio Biscegli
  surname: Jatene
  fullname: Jatene, Fabio Biscegli
  organization: Hospital das Clínicas Faculdade de Medicina Universidade de São Paulo Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP – Brasil
– sequence: 10
  givenname: Omar Asdrúbal Vilca
  surname: Mejia
  fullname: Mejia, Omar Asdrúbal Vilca
  organization: Hospital das Clínicas Faculdade de Medicina Universidade de São Paulo Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP – Brasil Hospital Samaritano Paulista Hospital Samaritano Paulista, São Paulo, SP – Brasil
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Issue 8
Keywords Cardiovascular Surgical Procedures
Saúde da Mulher
Outcome Assessment, Health Care
Avaliação de Resultados em Cuidados de Saúde
Procedimentos Cirúrgicos Cardiovasculares
Women’s Health
Language English
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Notes Potencial conflito de interesse
Editor responsável pela revisão: Alexandre Colafranceschi
Não há conflito com o presente artigo.
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Snippet Figura Central : Mais Complicações em Mulheres após Revascularização do Miocárdio Mesmo com Tempos Cirúrgicos Reduzidos: Atenção por Equidade e Melhoria da...
Resumo Fundamento Análises em grandes registros apontam desfechos desfavoráveis para mulheres submetidas à cirurgia de revascularização do miocárdio (CRM),...
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SubjectTerms Artigo Original
Avaliação de Resultados em Cuidados de Saúde
CARDIAC & CARDIOVASCULAR SYSTEMS
Procedimentos Cirúrgicos Cardiovasculares
Saúde da Mulher
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Title Mais Complicações em Mulheres após Revascularização do Miocárdio Mesmo com Tempos Cirúrgicos Reduzidos: Atenção por Equidade e Melhoria da Qualidade
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