ArticleBMJ open2021
Impact of surgeon and anaesthesiologist sex on patient outcomes after cardiac surgery: a population-based study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Operative Mortality for Male Versus Female Surgeons: A Systematic Review and Meta-Analysis.The Journal of surgical research · 2025Pooled it
- The association between physician sex and patient outcomes: a systematic review and meta-analysis.BMC health services research · 2025Pooled it
- The gender gap in academic anesthesiology and critical care medicine: a systematic review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025Pooled it
- Sex of surgeons and team composition and patients' length of stay after surgery: evidence from inpatient claims data in China.BMC medicine · 2026Article
- Patient-Surgeon Sex Concordance and Clinical Outcomes After Adult Cardiac Surgery.Journal of the American Heart Association · 2026Article
- Impact of surgeon caseload, case mix, and team composition on gender disparities in cholecystectomy outcomes.BJS open · 2025Article
- Association between anaesthesia-surgery team sex diversity and major morbidity.The British journal of surgery · 2024Article
- Surgeon Performance as a Predictor for Patient-Reported Outcomes After Arthroscopic Partial Meniscectomy.Orthopaedic journal of sports medicine · 2024Article
- Is self-advocacy universally achievable for patients? The experiences of Australian women with cardiac disease in pregnancy and postpartum.International journal of qualitative studies on health and well-being · 2023Article
- Sex Differences in the Outcomes of Degenerative Mitral Valve Repair.Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2023Article
- Operator-patient sex discordance and periprocedural outcomes of percutaneous coronary intervention (from the ORPKI Polish National Registry).Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2023Article
- Article
- Comparison of Multidimensional Frailty Instruments for Estimation of Long-term Patient-Centered Outcomes After Cardiac Surgery.JAMA network open · 2022Article
- Factors and Priorities Influencing Satisfaction with Care among Women Living with HIV in Canada: A Fuzzy Cognitive Mapping Study.Journal of personalized medicine · 2022Article
- Article
- A roadmap for surgeon leaders in improving gender equity: educational strategies, implementation, and evaluative methods.Canadian journal of surgery. Journal canadien de chirurgieArticle
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEffective teamwork between anaesthesiologists and surgeons is essential for optimising patient safety in the cardiac operating room. While many factors may influence the relationship between these two physicians, the role of sex and gender have yet to be investigated.
objectivesWe sought to determine the association between cardiac physician team sex discordance and patient outcomes.
designWe performed a population-based, retrospective cohort study. PARTICIPANTS AND
settingAdult patients who underwent coronary artery bypass grafting (CABG) and/or aortic, mitral or tricuspid valve surgery between 2008 and 2018 in Ontario, Canada. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was all-cause 30-day mortality. Secondary outcomes included major adverse cardiovascular events at 30 days and hospital and intensive care unit lengths of stay (LOS). Mixed effects logistic regression was used for categorical outcomes and Poisson regression for continuous outcomes.
results79 862 patients underwent cardiac surgery by 98 surgeons (11.2% female) and 279 anaesthesiologists (23.3% female); 19 893 (24.9%) were treated by sex-discordant physician teams. Physician sex discordance was not associated with overall patient mortality or LOS; however, patients who underwent isolated CABG experienced longer hospital LOS when treated by an all-male physician team as compared with an all-female team (adjusted OR=1.07; p=0.049). When examining the impact of individual physician sex, the length of hospital stay was longer when isolated CABG procedures were attended by a male surgeon (OR=1.10; p=0.004) or anaesthesiologist (OR=1.02; p=0.01).
conclusionsPatient mortality and length of stay after cardiac surgery may vary by sex concordance of the attending surgeon-anaesthesiologist team. Further research is needed to examine the underlying mechanisms of these observed relationships.
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