Intraabdominal surgeries are frequently performed procedures that lead to a high volume of unplanned readmissions and postoperative complications. Patient sex may be a determinant of adverse outcomes in this population, possibly due to differences in biology or care delivery, but it is understudied. The authors hypothesized that there would be no association between patient sex and the risk of postoperative adverse outcomes in intraabdominal surgery.
This retrospective, population-based cohort study involved adult inpatients aged 18 yr or older who underwent intraabdominal surgeries in Ontario, Canada, between April 2009 and March 2016. The authors studied the association of patient sex on the primary composite outcome of all-cause death, hospital readmission, or major postoperative complications, all within 30 postoperative days. Inverse probability of exposure weighting based on propensity scores (computed using demographic characteristics such as rural residence status and median neighborhood income quintile, common comorbidities, and surgery- and hospital-specific characteristics) was used to estimate the adjusted association of sex on outcomes.
The cohort included 215,846 patients (52.3% female). The primary outcome was observed in 24,712 (21.9%) females and 25,486 (24.7%) males (unadjusted risk difference, 2.8% [95% CI, 2.5 to 3.2%]; P < 0.001). After adjustment, the association between the male sex and the primary outcome was not statistically significant (adjusted risk difference, −0.2% [95% CI, −0.5 to 0.2%]; P = 0.378).
In a large population of intraabdominal surgical patients, there was no differential risk between sexes in the composite outcome of all-cause death, hospital readmission, or major postoperative complications, all within 30 postoperative days.
- Sex-based disparities exist for outcomes after cardiac surgery, trauma care, and postoperative sepsis
- Previous analyses of general surgery patients using U.S. administrative data have demonstrated that female sex may be associated with lower rates of complications, but the reproducibility of this observation is unclear
- Among 215,846 patients undergoing major inpatient abdominal surgery in Ontario, Canada, from 2009 to 2016, 24,712 females (21.9%) and 25,486 males (24.7%) experienced death, readmission, or major complications, all within 30 days
- After adjusting for comorbidities, surgical details, and sociodemographic factors, patient sex was not associated with a statistically significant difference in the composite outcome of death, readmission, or major complications