Operator-patient sex discordance and periprocedural outcomes of percutaneous coronary intervention (from the ORPKI Polish National Registry)

• Published in: Postępy w kardiologii interwencyjnej 2023-06, Vol.19 (2), p.113-118
• Main Authors: Dziewierz, Artur, Vogel, Birgit, Zdzierak, Barbara, Kuleta, Martyna, Malinowski, Krzysztof P, Rakowski, Tomasz, Piotrowska, Aleksandra, Mehran, Roxana, Siudak, Zbigniew
• Format: Article
• Language: English
• Subjects: complications; doctor-patient interaction; gender; Original Paper; patient-physician relationship; sex
• ISSN: 1734-9338; 1897-4295
• DOI: 10.5114/aic.2023.129208

A recent study suggested that sex discordance between surgeons and patients negatively affects the outcomes of patients undergoing common surgical procedures. We sought to assess whether such an impact exists for periprocedural outcomes of percutaneous coronary intervention (PCI). From 2014 to 2020, data on 581,744 patients undergoing single-stage coronary angiography and PCI from 154 centers were collected. Patients were divided into four groups based on the patient and operator sex. Operator-patient sex discordance was defined as the procedure done by a male operator on a female patient or by a female operator on a male patient. Of 581,744 patients treated by 34 female and 782 male operators, 194,691 patients were sex discordant with their operator (female operator with male patient 12,479; male operator with female patient 182,212) while 387,053 were sex concordant (female operator with female patient 6,068; male operator with male patient 380,985). Among female patients, no difference in the risk of periprocedural complications, including death (0.65% vs. 0.82%; = 0.10), between patients discordant versus concordant with operators was observed. Among male patients the risk of death (0.55% vs. 0.43%; = 0.037) and bleeding at the puncture site (0.13% vs. 0.08%; = 0.046) was higher in patients discordant with operators. However, the differences were no longer significant after adjustment for covariates. No detrimental effect of operator-patient sex discordance on periprocedural outcomes was confirmed in all-comer patients undergoing PCI. Some of the observed differences in outcomes were primarily related to the differences in baseline risk profile.