Patient‐Surgeon Sex Concordance and Clinical Outcomes After Adult Cardiac Surgery

Background Patient–surgeon sex concordance influences postoperative outcomes in general surgery, but its relevance in cardiac surgery is unknown. Methods This was a cohort study of 223 065 Medicare beneficiaries undergoing coronary artery bypass grafting, surgical aortic valve replacement, and/or proximal aortic surgery from 2010 to 2021, stratified by surgeon and patient sex. The primary and secondary outcomes were composites of mortality and morbidity (myocardial infarction, stroke, and all‐cause readmission) at 30 days and 5 years postoperatively, respectively. Multivariable regression analysis identified independent associations. Results The male surgeon–male patient group comprised 59.9% (133 533/223 065), the female surgeon–male patient group comprised 8.3% (18 623/223 065), the female surgeon–female patient group comprised 3.8% (8466/223 065), and the male surgeon–female patient group comprised 28.0% (62 443/223 065) of the cohort. There was no difference in the incidence of the 30‐day composite outcome between groups and no independent association of sex concordance with the 30‐day composite outcome (odds ratio sex discordance, 1.00 [95% CI, 0.96–1.04]; P =0.84); the interaction between patient sex and sex discordance was not significant ( P =0.75). The incidence of the 5‐year composite outcome was higher in the male surgeon–male patient than the female surgeon–male patient group (67.2% [89 795/133 533] versus 65.3% [12 160/18 623]; P