A new study from the University of Michigan has found that women are more likely to die from complications after high-risk heart surgery than men, even though both sexes experience complications at the same rate.
The research, published in JAMA Surgery, highlights a critical gap in post-surgical care that may be putting female patients at greater risk.
In medicine, when a patient dies from a complication that could have been managed, it is called a “failure to rescue.”
The study analyzed over 850,000 cases of Medicare patients who underwent major cardiovascular procedures, including heart bypass surgery, aortic aneurysm repair, and mitral and aortic valve repair, between 2015 and 2020.
The results showed that men and women had a similar rate of complications—around 15%—but women were more likely to die when these complications occurred. Specifically, surgical teams failed to rescue female patients 10.7% of the time, compared to 8.6% for male patients.
Why Are More Women Dying After Surgery?
The study found that this pattern was consistent across different types of heart surgery. The most common complications—kidney failure, pneumonia, and lung failure—occurred at similar rates in both men and women. However, the ability to treat these complications successfully was lower in female patients.
Researchers also ruled out hospital quality as a cause of the disparity. In fact, women were more likely than men to have their surgeries at high-volume hospitals that frequently perform these procedures. This suggests that the issue is not about hospital experience, but rather how complications in female patients are recognized and managed.
Dr. Catherine Wagner, the study’s lead author and a resident in thoracic surgery at the University of Michigan, emphasized that these findings reveal a major issue in the U.S. healthcare system. “We are failing to rescue women after high-risk surgery even though the rate of complications is similar to men,” she said.
One key difference found in the study was that women were less likely to undergo a second surgery, or reoperation, within days of their first procedure. While this could mean they needed fewer additional surgeries, researchers believe it is more likely that their complications were not being properly addressed in time.
Dr. Gorav Ailawadi, co-author of the study and chair of cardiac surgery at the University of Michigan, explained, “These high-risk procedures naturally come with a higher chance of complications, but patients are expected to recover if those complications are managed quickly.
In our study, women had a lower rate of reoperation than men, which could be a sign that their complications were not being recognized or treated appropriately.”
Gender Disparities in Heart Health
This study adds to a growing body of research showing that women often experience worse outcomes after heart procedures. In the past, doctors have suggested that women are more vulnerable to surgical risks because they tend to be older at the time of surgery, have more preexisting health conditions, and have smaller blood vessels, which can make surgery more complex.
However, the new study controlled for these factors and still found that women were more likely to die from post-surgical complications.
This issue is part of a larger trend in medicine where women’s symptoms and medical needs are often overlooked. Previous research has shown that signs of heart attacks and strokes are more frequently missed or dismissed in female patients compared to male patients.
Dr. Andrew Ibrahim, a co-author of the study and associate professor of surgery at the University of Michigan, stressed that doctors must improve how they recognize and respond to complications in female patients.
“In addition to reducing complications overall, we must focus on what happens after a complication occurs,” he said. “We need to improve early recognition when a female patient is having a complication before it reaches a point where we cannot rescue them.”
Addressing the Gender Gap in Medical Research
For many years, women have been underrepresented in medical research, leading to gaps in knowledge about how diseases and treatments affect them differently. Recognizing this, the National Institutes of Health (NIH) introduced a policy in 2016 requiring that sex differences be considered in research studies. However, more work is needed to close these gaps.
Dr. Wagner emphasized that addressing these disparities goes beyond individual hospitals—it requires a larger effort to improve how sex differences are studied in medical research.
“We need to continue examining sex differences in biomedical research to address the longstanding neglect of women’s health,” she said. “By identifying the underlying reasons for these disparities, we can improve outcomes for all patients.”
What Can Be Done?
To reduce these deaths, hospitals and doctors must focus on:
- Improving early detection of complications in women – Ensuring that symptoms are taken seriously and acted upon quickly.
- Reevaluating post-surgical care strategies – Making sure that treatment plans are tailored to the specific needs of female patients.
- Increasing awareness among medical professionals – Educating doctors and nurses about gender disparities in surgical outcomes.
- Encouraging more research on sex differences in surgery – Investing in studies that focus specifically on how men and women respond differently to surgical procedures and complications.
This study provides a wake-up call for the medical community to take a closer look at gender disparities in post-surgical care. While high-risk heart surgeries will always carry risks, improving how complications are recognized and treated—especially in women—could save thousands of lives.
If you care about heart health, please read studies that vitamin K helps cut heart disease risk by a third, and a year of exercise reversed worrisome heart failure.
For more health information, please see recent studies about supplements that could help prevent heart disease, stroke, and results showing this food ingredient may strongly increase heart disease death risk.
The research findings can be found in JAMA Surgery.
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