Gender as a Moderator Between Having an Anxiety Disorder Diagnosis and Coronary Artery Bypass Grafting Surgery (CABG) Outcomes in Rural Patients


For further information, contact: Tam Dao, PhD, Assistant Professor, University of Houston, Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, Houston, TX 77030; e-mail


Purpose: This paper examines gender as a moderating variable between having an anxiety disorder diagnosis and coronary artery bypass grafting surgery (CABG) outcomes in rural patients.

Methods: Using the 2008 Nationwide Inpatient Sample (NIS) database, 17,885 discharge records of patients who underwent a primary CABG surgery were identified. Independent variables included age, gender, race, median household income based on patient's ZIP code, primary expected payer, the Deyo, Cherkin, and Ciol Comorbidity Index, and an anxiety comorbidity diagnosis. Outcome variables included in-hospital length of stay and patient disposition (routine and nonroutine discharge). A 2 × 2 analysis of variance and logistic regression analyses were used to assess the interaction between gender and an anxiety disorder diagnosis on in-hospital length of stay and patient disposition.

Findings: Twenty-seven percent of rural patients undergoing a CABG operation had a comorbid anxiety diagnosis. Rural patients who had nonroutine discharge were more likely to have comorbid anxiety diagnosis compared to rural patients who had a routine discharge. There was a significant interaction effect between having an anxiety diagnosis and gender on length of hospital stay but not for patient disposition.

Conclusions: Three findings were noteworthy. First, anxiety disorder is prevalent in rural patients who are undergoing a CABG operation. Second, anxiety was a significant independent predictor of both length of hospital stay and nonroutine discharge for patients receiving CABG surgery. Last, having an anxiety disorder diagnosis increased hospital stay for both males and females; however, females seemed to be impacted more than males.