183 Comparison Between Men and Women Admitted to an Inpatient Rehabilitation Unit After Cardiac Surgery Adrian Cristian, MD, Kathleen Mandy, MD, Barry Root, MD ABSTRACT. Cristian A, Mandy K, Root B. Comparison between men and women admitted to an inpatient rehabilitation unit after cardiac surgery. Arch Phys Med Rehabil 1999;80: 183-5. Objective: To determine whether there are differences in several factors between men and women who undergo inpatient post-cardiac surgery rehabilitation. Design: A retrospective chart review. Information was col- lected on a variety of factors: age; previous myocardial infarction; number of days from surgery to admission to rehabilitation; postsurgery, prerehabilitation complications; length of stay on the rehabilitation unit; living arrangements before surgery; disposition; and postdischarge recommenda- tions . Setting: Community hospital rehabilitation unit associated with a university hospital. Patients: One hundred thirty-eight patients (54 men, 84 women) admitted to an inpatient rehabilitation unit after cardiac surgery. Results: There was a significant relationship between sex and preadmission living arrangements; 56% of women lived alone versus 26% of men (p < .Ol). There was a statistically significant difference in length of stay on the rehabilitation unit (p < .02). Men stayed longer, with a median stay of 16 days (95% confidence interval, 15 to 20) versus 15 days for women (95% confidence interval, 14 to 15). Ninety-three percent of men were discharged from rehabilitation at 30 days versus 98% of women. No relationship was noted between men and women in age, previous myocardial infarction, number of days from surgery to rehabilitation admission, length of stay on the rehabilitation unit, postsurgery-prerehabilitation complications, complications on the rehabilitation unit, presurgery living arrangements, disposition, and postdischarge therapy recommen- dations. Conclusion: Men and women showed comparable courses after cardiac surgery. Before surgery, women lived alone more frequently than men. 0 1999 by the American Congress of Rehabilitation Medi- cine and the American Academy of Physical Medicine and Rehabilitation C ORONARY ARTERY DISEASE and heart valve disease are significant causes of morbidity and mortality for men and women in the United States. Given the successful outcomes of heart surgery, Americans are undergoing coronary revascular- From the Division of Physical Medicine and Rehabilitation, North Shore University Hospital-Glen Cove, Glen Cove, NY. Submitted for publication June 8, 1998. Accepted in revised form August 31, 1998. No commercial party having a. direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated. Reprint requests to Adrian Cristian, MD, Department of Physical Medicine and Rehabilitation, Room 3D06, The Bronx Veterans Affairs Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468-3992. 0 1999 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation 0003.9993/98/8002-5068$3.00/O ization surgery and valve replacement surgeries more fre- quently. Often, these patients are more medically compromised and have less developed social networks. As a result, they are being referred more frequently for inpatient rehabilitation after their heart surgeries. Numerous studies have indicated differ- ences between men and women in both the diagnosis and invasive treatment of heart disease. In the Framingham study,l women were found to be more prone to death and reinfarction than men. Women hospitalized for coronary artery diseasewere referred less often than men for angiograms and revasculariza- tion procedures.2-6When women were referred for coronary revascularization surgery, they were often older and sicker.’ Women were found to have higher rates of complications after percutaneous transluminal coronary angioplasty’ and higher mortality rates after coronary artery bypass graft (CABG) surgery. 8,9 Attempts to explain these sex differences in operative mortality included hypotheses that women were of smaller stature and had smaller coronary artery diameters than men.9J0 Nevertheless, long-term survival rates after CABG were similar for both men and women.lOJ1 With respect to outpatient cardiac rehabilitation programs, women responded as well as men, but had poorer attendance and higher dropout rates.12J3 The purpose of this study was to identify any post-cardiac surgery gender differences, given that previous studies have found women to be sicker at the time of surgery. MATERIALS AND METHODS The charts of 138 patients (84 women and 54 men) admitted to a rehabilitation unit soon after CABG and/or valve replace- ment surgery were reviewed retrospectively. The criterion for admission to the rehabilitation unit’s cardiac program was a significantly diminished endurance for activities of daily living and ambulation after cardiac surgery. Because of the myriad of referral sources, the number of patients who had been discharged directly to home after cardiac surgery could not be ascertained. The following factors were compared between men and women: age; presurgical myocardial infarction; total number of days from surgery to admission to the rehabilitation unit (DAYSSR); length of stay (LOS) on the unit, measured in days; postsurgical complications before admission to the unit (pres- ence and size of pleural effusion, arrhythmias, confusion, acute congestive heart failure, prolonged intubation, cerebrovascular accident, cellulitis, deep vein thrombosis [DVT], pulmonary embolism [PE]; urinary tract infection, presence of a feeding tube and/or tracheostomy); complications on the unit (arrhyth- mias, PE, congestive heart failure, incidence of depression, cellulitis, DVT/PE, urinary tract infection drug reactions, chest pain episodes); acute transfer rates; social status; prior living arrangements; postdischarge living arrangements; postdis- charge recommendation for further physical therapy (home vs outpatient therapy). Statistical Methods The relation between sex and all categorical factors listed above was determined using the x2 or Fisher exact test, as Arch Phys Med Rehabil Vol 80, February 1999