According to new research presented at Euroanaesthesia, the annual meeting of the European Society of Anesthesiology and Intensive Care (ESAIC), middle-aged men are about 50% more likely to die after surgery than women.
The study of more than 100,000 non-cardiac patients in a major German hospital found that death rates are highest in men in their 40s and 50s, as well as in those in their 60s and 70s.
Surgery gap
Dimislav Andonov and his colleagues at the Technical University of Munich, Munich, Germany, analyzed data from 107,471 patients who had undergone non-cardiac surgery at the university hospital between January 2014 and March 2020.
Procedures included a wide range of operations, such as hip replacements and cancer surgery, and emergency surgeries, such as acute appendicitis and operations on car accident victims. Outpatient and outpatient cases, diagnostic procedures under anesthesia, electroconvulsive therapy and patients who were in the ICU before their operation were excluded.
No relationship was found between the sex of a patient and the probability that he or she was admitted to the post-anesthesia care unit or in the PACU for prolonged postoperative follow-up (Patients who spend more than four hours in the postanesthetic recovery room are defined as being in the PACU). There was also no relationship between sex and admission to the ICU, the need to be connected to a ventilator or death before being discharged from the hospital in those under 40 years of age.
But, in the 41- to 80-year-old age group, men were more likely to be admitted to the ICU, need ventilation, and die before discharge than women of the same age. Men ages 41 to 60 were 22% more likely to be admitted to the ICU than women of the same age, 37% more likely to need ventilation, and 54% more likely to die.
Women between the ages of 61 and 80 were 20% more likely to be admitted to the ICU than women of the same age, 31% more likely to need ventilation, and 38% more likely to die.
Possible causes
It’s not clear why the risks are higher for men ages 41 to 80, but one possibility is that higher rates of cardiovascular problems in men increase the likelihood of surgical complications.
In addition, the results may be biased by the inclusion of trauma cases, such as car accident injuries, which are often life threatening and are more common in men.