• Keerat Grewal, Duminda N Wijeysundera, Jo Carroll, Gordon Tait, and W Scott Beattie.
• Department of Anesthesia and Pain Management, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada.
• Can J Anaesth. 2012 Mar 1; 59 (3): 255-62.

PurposeAlthough inequality between males and females in cardiovascular surgery is well recognized, few studies have examined the influence of sex on mortality following non-cardiovascular surgery. The objective of the study was to determine whether there are differences in mortality between males and females following non-cardiovascular surgery and to ascertain to what extent preoperative risk factors explain these differences.MethodsThis was an observational study of 39,433 consecutive non-cardiovascular inpatient surgical cases from non-sex-biased surgical services from 2003 to 2009. Data on the surgical procedure, patient risk factors, and outcomes was retrieved from the institutional Electronic Data Warehouse. The primary outcome was in-hospital mortality within 30 days of surgery. Multivariate analysis using logistic regression was conducted to determine the role of risk factors for mortality.ResultsThe 30-day mortality was 2.76% for males and 1.89% for females (odds ratio, 1.47; 95% confidence interval [CI], 1.29 to 1.69). Logistic regression showed that age, number of Charlson comorbidities, American Society of Anesthesiologists (ASA) classification, and emergent/urgent status were independent predictors of mortality (receiver operating characteristic area, 0.90). After adjustment for these factors, the odds ratio for male mortality was reduced to 1.31 (95% CI, 1.14 to 1.52).ConclusionMales present for non-cardiovascular surgery with a higher ASA classification, with more comorbidities, and more often emergently than females, providing a partial explanation of the observed difference in mortality.

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