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Dr. John Bozinovski adds to study on sex differences in surgery outcomes

Island Health cardiac surgeon Dr. John Bozinovski recently co-wrote a study in Circulation, a peer-reviewed American Heart Association journal dedicated to cardiovascular health and disease. The article, Sex-Related Differences in Patients Undergoing Thoracic Aortic Surgery, draws on evidence from the Canadian Thoracic Aortic Collaborative to compare how men and women fare after heart surgery. Since its release in February, the article has received national and international media coverage and ranked second in most-read Circulation articles last week.

Dr. Bozinovski and co-authors studied the differences in outcomes between men and women after thoracic aortic surgery with hypothermic circulatory arrest – this is a type of heart surgery where the surgeons cool the body temperature to stop blood circulation and brain function in order to operate on the heart. Post-surgery outcomes they compared included follow-up operations, circulatory arrest, mortality and more. 1653 men and women who had this operation in Canada between 2002 and 2015 were included in the study.

The authors found that women experience worse outcomes than men. Further investigation is required to better determine how to reduce the gap.

Lead author Dr. Jennifer Chung said “This helps us understand that surgery shouldn't be the same for men and women, and that we must educate ourselves about picking up symptoms in women sooner.”

Dr. Bozinovski said the study “is only a first step as it did not provide indisputable causes for the disparity seen between genders. But disparity means improvement may be possible. We must take into account the individual and, as best possible, offer them a personalized treatment plan based on quality evidence.”

Island Health cardiologist Dr. Daisy Dulay said “The Heart Health program is proud of Dr. Bozinovski’s contribution to this important study and hope that further research will help reduce the difference in outcomes for women. The level of awareness that Circulation brings can only help.”

Sex-Related Differences in Patients Undergoing Thoracic Aortic Surgery is available online at www.ahajournals.org.