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Author Vigoda, Michael M. ♦ Rodríguez, Luis I. ♦ Wu, Eric ♦ Perry, Kevin ♦ Duncan, Robert ♦ Birnbach, David J. ♦ Lubarsky, David A.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Lippincott Williams & Wilkins
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Social sciences ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Chemistry & allied sciences ♦ Life sciences; biology ♦ Physiology & related subjects ♦ Biochemistry ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Human physiology ♦ Pharmacology and therapeutics ♦ Diseases ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Cardiovascular Diseases ♦ Diseases ♦ Organic Chemicals ♦ Chemical Actions and Uses ♦ Chemicals and Drugs ♦ Therapeutics ♦ Anesthesia and Analgesia ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Reproductive and Urinary Physiological Phenomena ♦ Biological Sciences ♦ Persons ♦ Persons ♦ Health Care Facilities, Manpower, and Services ♦ Health Care
Subject Keyword Discipline Anesthesiology ♦ Anesthesia ♦ Coronary Artery Disease ♦ Drug Therapy ♦ Medical Records Systems, Computerized ♦ Adrenergic Beta-antagonists ♦ Therapeutic Use ♦ Adult ♦ Aged ♦ Aspirin ♦ Female ♦ Humans ♦ Hydroxymethylglutaryl-coa Reductase Inhibitors ♦ Logistic Models ♦ Male ♦ Middle Aged ♦ Outpatient Clinics, Hospital ♦ Preoperative Care ♦ Retrospective Studies ♦ Sex Characteristics ♦ Journal Article
Abstract BACKGROUND: Previous anesthesia information management systems-based studies have focused on intraoperative data analysis. Reviewing preoperative data could provide insight into the outpatient treatment of patients presenting for surgical procedures. As gender-based disparities have been demonstrated in the treatment of patients with cardiac disease, we hypothesized that there would be gender disparities in the outpatient pharmacologic management of patients with coronary artery disease (CAD) scheduled for elective noncardiac surgery. METHODS: We analyzed electronic medical records of ambulatory patients with CAD (prior myocardial infarction [MI], coronary artery bypass surgery, and angioplasty with or without stenting, angina) presenting for elective noncardiac surgery between 1/2004 and 6/2006 (30 mo) at an inner city hospital. RESULTS: Of 21,039 ambulatory patients seen in the preanesthesia clinic, 6.4% (1346) had CAD. Patients with CAD: Men were more likely to be taking beta-blockers (P < 0.002), statins (P < 0.0001), aspirin (P < 0.0001), and antiplatelet medications (P < 0.04), although there was a trend of increased use of aspirin (P < 0.01) by women over the course of the study. Patients with history of prior MI: Men with a prior MI were more likely to be taking beta-blockers (P < 0.0001) and statins (P < 0.02), although there was a trend of increased use of beta-blockers (P < 0.0005) and aspirin (P < 0.03) by women over the course of the study. Quarterly prevalence rates for outpatient medication use were greatest for beta-blockers and least for aspirin. Patients were more likely to be taking a statin, aspirin, or oral antiplatelet medication if they were receiving chronic beta-blocker therapy (P < 0.0001 for each medication). CONCLUSION: Aggregating anesthesia management information systems data provides an epidemiological perspective of community care of patients presenting for surgery. We found that gender disparities in outpatient medical treatment of patients with CAD, which previously favored men, have diminished primarily as a result of increased use of these medications in women. Nonetheless, despite evidence supporting the use of risk-reduction strategies, our patients are undertreated with standard medical therapies.
Description Country affiliation: United States
Author Affiliation: Vigoda MM ( Center for Informatics and Perioperative Management, Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami/Jackson Memorial Hospital, Miami, Florida, USA. mvigoda@med.miami.edu)
ISSN 00032999
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2008-07-01
Publisher Place United States
e-ISSN 15267598
Journal Anesthesia & Analgesia
Volume Number 107
Issue Number 1


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Source: WHO-Global Index Medicus