Journal of

Background and Aim: Females were reported to have significantly lower hematocrit (Hct), which might be the cause of increased need for blood transfusion. The goal of this study is to determine risk factors affecting blood transfusion in patients undergoing coronary artery bypass graft procedure related to gender

Materials and Methods: A cross sectional review of 500 (306 males and 194 females) ASA physical status I or Il patients undergoing bypass procedures with saphenous vein graft performed over a one year period were included in this study. The conducting of anesthesia was standardized. For each patient, we recorded the gender, age, body weight, height, body surface area (BSA), and duration of surgery. Hematocrit levels prior to surgery and the end of surgery were recorded. Packed red blood cell (PRBC) administration and use of fresh frozen plasma (FFP) and platelets were noted. Differences between the data for female and male patients were evaluated using Student's t-test, Chi-square test and using regression analysis.

Results: Approximately 57.2 % (111) female and only 39.9% (121) male patients received PRBCs. On average, females received 1. 6 units of PRBCs intraoperatively and 2. 6 units of PRBCs during the entire hospital stay, while the males received 1.1 units and 1.8 units for similar periods (P=0.0001). When females and males were compared within the same subgroups for age, body surface area (BSA), duration of surgery, and preoperative Hct, etc. ...had a significant correlation with age, postoperative Hct and BSA in females but had a significant correlation with preoperative Hct, preoperative PRBC and duration of surgery in males (P<0.05). Multiple logistic regression analysis showed that the probability of a patient receiving or not receiving PRBC transfusion is significantly influenced by preoperative Hct, postoperative Hct, duration of surgery, preoperative PRBC mass, and gender.

Discussion and Conclusion: Gender is an independent essential determinant of blood transfusion in CABG patients, and may interact with BSA, preoperative Hct, duration of surgery and other factors in determining the probability of transfusion.

Background and Aim: Pre-hospital delay is an important cause of increasing mortality in acute myocardial Infarction. There are conflicting data regarding the relationship between sex and pre-hospital delay for patients with acute myocardial Infarction. The aim of the present study was to determine the relationship between pre-hospital delay and sex.

Materials and Methods: This cross-sectional survey was conducted on 162 consecutive patients with acute myocardial Infarction admitted to Cardiac Care Unit (CCU) in Dr. Heshmat hospital in Rasht between May 2010 and September 2011. A convenient sampling method was used. All patients were interviewed within 7 days after admission by using a data collection form.

Results: Mean of pre-hospital delay for women was more than men. Majority of men had chest pain. The women often experienced different and non specific symptoms compared to men. Regression analysis showed no significant relationship between patients' characteristics and pre-hospital delay in women whilst, pre-hospital delay was significantly related to perceiving symptoms to be serious and interpreting symptoms to a cardiac origin in men.

Conclusion: Results of the current study suggest that pre-hospital delay for women was longer than men with acute myocardial Infarction as women often experienced no specific symptoms compared to men. Therefore, it recommended that clinicians educate public, particularly women, on acute myocardial infarction to enable them to recognize the signs and symptoms of acute myocardial infarction correctly and realize the benefits of early treatment.

  Background and Aim: Gender in performing self-care behaviors is a non- modifiable factor. Despite the belief that women are better than men in self-care, there is little evidence to challenge this view. The purpose of this study was to determine the status of self-care behaviors in men and women with heart failure.

  Materials and Methods: In this analytical cross-sectional study, 239 patients with heart failure were assessed. Data were collected by Self-Care Heart Failure Index, Cardiac Depression scale, and Mini Mental status Examination questionnaires . Data were analyzed using SPSS version 19 , descriptive and inferential statistics (Chi-Square, Mann-Whitney, Kruskal-Wallis , t-test and Logistic regression ) .

  Results: Mean score of self-care behaviors in men and women was 44/60±12/05 and 39/71 ± 9/88 from 100 total score, respectively. In the regression model, gender was not a significant predictor of self-care in any dimensions but, there was a significant relationship between sex and self-care confidence (OR=0/52, CI=0/27-1/03), which indicated that women as compared to men have less chance of self-care behaviors due to their status of self-confidence.

  Conclusion : In attention to the point that women had worse self-care behaviors in all dimensions, it is suggested more attention be paid in identifying patients at risk of poor self-care behaviors while planning care and treatment for them, since they are more vulnerable and have more emotional effects of disease and gender should be regarded as a predictive factor.