Differences in postoperative outcomes after carotid endarterectomies performed by female versus male surgeons

  • To evaluate whether sex of the operating surgeon influences postoperative outcomes after carotid endarterectomy (CEA). We hypothesized that patients treated by female surgeons have lower complication rates or mortality. Methods: A retrospective, single-center analysis was conducted of all CEA procedures performed between January 2012 and December 2023 by the Clinic of Vascular Surgery of the University Hospital Augsburg. Patient demographics, comorbidities, and operative details were collected from the german national quality assurance database. The primary outcomes included perioperative complications and 30-day mortality. Secondary outcomes included operative time and surgical technique preference. Outcomes were compared between cases performed by male and female surgeons using univariate analysis and multivariable logistic regression. Results: A total of 1 130 CEA operations met the inclusion criteria. Of these, 905 (80.1%) were performed by male surgeons and 225 (19.9%) by femaleTo evaluate whether sex of the operating surgeon influences postoperative outcomes after carotid endarterectomy (CEA). We hypothesized that patients treated by female surgeons have lower complication rates or mortality. Methods: A retrospective, single-center analysis was conducted of all CEA procedures performed between January 2012 and December 2023 by the Clinic of Vascular Surgery of the University Hospital Augsburg. Patient demographics, comorbidities, and operative details were collected from the german national quality assurance database. The primary outcomes included perioperative complications and 30-day mortality. Secondary outcomes included operative time and surgical technique preference. Outcomes were compared between cases performed by male and female surgeons using univariate analysis and multivariable logistic regression. Results: A total of 1 130 CEA operations met the inclusion criteria. Of these, 905 (80.1%) were performed by male surgeons and 225 (19.9%) by female surgeons. Patient characteristics were comparable between the two groups. Male surgeons more frequently used eversion endarterectomy (OR for eversion by male vs. female surgeon 1.65, 95% CI 1.02-2.67, p = 0.04). The median incision-to-suture operative time was longer under female surgeons (101 minutes [IQR 87-118] vs. 86 [70-106] minutes for male surgeons, p<0.001). The rate of any perioperative complication was 4.4% for female surgeons vs. 6.6% for male surgeons (p = 0.32). Thirty-day mortality was low in both groups (0.4% vs. 0.7%, p = 0.67). Conclusions: Surgeon sex was not associated with significant differences in perioperative complications or mortality following CEA. Female surgeons had significantly longer operative times, without negatively impacting patient outcomes. These findings support sex equity in vascular surgery.show moreshow less

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Metadaten
Author:Stefan IonacORCiD, Hagen KerndlORCiD, Tobias Dominik WarmORCiDGND, Alexander Hyhlik-DürrORCiDGND, Yvonne GosslauORCiDGND
URN:urn:nbn:de:bvb:384-opus4-1263710
Frontdoor URLhttps://opus.bibliothek.uni-augsburg.de/opus4/126371
ISSN:0890-5096OPAC
Parent Title (English):Annals of Vascular Surgery
Publisher:Elsevier BV
Place of publication:Amsterdam
Type:Article
Language:English
Year of first Publication:2026
Publishing Institution:Universität Augsburg
Release Date:2025/11/24
Volume:124
First Page:63
Last Page:71
DOI:https://doi.org/10.1016/j.avsg.2025.11.005
Institutes:Medizinische Fakultät
Medizinische Fakultät / Universitätsklinikum
Medizinische Fakultät / Lehrstuhl für Gefäßchirurgie
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):CC-BY 4.0: Creative Commons: Namensnennung