To the Editor.
—By combining men and women in their analysis of 5051 consecutive patients (of whom 1040 [20.6%] were women) Higgins et al1 may have weakened the power of their excellent clinical severity score for coronary artery bypass patients.Even taking into account the possibility of a misprint in the abstract, where a "body weight of 65 kg or more" was stated to be "predictive of morbidity," the issue of body weight requires some clarification. All three tables in the article identify weight that is 65 kg or less as a "preoperative factor" increasing the odds ratios, and the "Comment" section clearly refers to low body weight as an independent risk factor. Though the present study did not identify female gender as a risk factor (in contrast to other reports), the authors subscribe to the idea that smaller body size might explain increased risk in women. It is
Kral JG. Weighing the Risk Factors in Coronary Artery Bypass Surgery. JAMA. 1992;268(14):1857. doi:10.1001/jama.1992.03490140065026