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Gender Bias Found in Bypass Surgery

By HospiMedica staff writers
Posted on 17 Mar 2005
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A study has found that the odds of a woman meeting the criteria for bypass surgery but not receiving the procedure are about double that of comparable men. The study's findings were reported in the March 2005 issue of Psychology of Women Quarterly.

To find the reasoning behind this discrepancy, patient information from the U.S. National Hospital Discharge Survey for 1988 and 1998 was examined by the study's author, Cheryl B. Travis, professor of psychology and chair of women's studies at the University of Tennessee Knoxville (USA). The common explanations were that women do not have the appropriate diagnoses, they have complicating conditions that make them a poor risk, they are too elderly and frail to benefit, and the surgery carries a greater risk of mortality for women. However, none of these were supported in any way, suggesting that the real explanation may be gender bias.

Controlling for primary diagnoses of heart attack, obstructed blood flow to the heart, or angina had little effect on the gender disparity. Data from the study showed that among patients with heart attacks who received bypass, there were only 59 recipients for every 100 men who received bypass surgery. Women with comorbid conditions such as diabetes or hypertension were found to have significantly more conservative treatment decisions than men with the same conditions. Similarly, women were found twice as likely not to receive the surgery compared to men in the same age group. Women in their 40s, for example, experienced more than a three-fold risk of not receiving the surgery over men in their forties

Medical literature has typically reported a higher risk of mortality among women patients but always in comparison to men. "For purposes of women's decision-making, mortality risk should be considered as it is assessed among and referenced to women with comparable medical profiles,” advised Dr. Travis. In fact, women having medical conditions consistent with bypass surgery have been found to be more likely than control women to survive hospitalization if they receive the surgery.




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