1. Sex-Related Differences and Factors Associated with Peri-Procedural and 1 Year Mortality in Chronic Limb-Threatening Ischemia Patients from the CLIMATE Italian Registry
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Eugenio Martelli, Matilde Zamboni, Giovanni Sotgiu, Laura Saderi, Massimo Federici, Giuseppe M. Sangiorgi, Mariangela V. Puci, Allegra R. Martelli, Teresa Messina, Paolo Frigatti, Maria Pia Borrelli, Carlo Ruotolo, Ilaria Ficarelli, Paolo Rubino, Francesco Pezzo, Luciano Carbonari, Andrea Angelini, Edoardo Galeazzi, Luca Calia Di Pinto, Franco M. Fiore, Armando Palmieri, Giorgio Ventoruzzo, Giulia Mazzitelli, Franco Ragni, Antonio Bozzani, Enzo Forliti, Claudio Castagno, Pietro Volpe, Mafalda Massara, Diego Moniaci, Elisa Pagliasso, Tania Peretti, Mauro Ferrari, Nicola Troisi, Piero Modugno, Maurizio Maiorano, Umberto M. Bracale, Marco Panagrosso, Mario Monaco, Giovanni Giordano, Giuseppe Natalicchio, Antonella Biello, Giovanni M. Celoria, Alessio Amico, Mauro Di Bartolo, Massimiliano Martelli, Roberta Munaó, Davide Razzano, Giovanni Colacchio, Francesco Bussetti, Gaetano Lanza, Antonio Cardini, Bartolomeo Di Benedetto, Mario De Laurentis, Maurizio Taurino, Pasqualino Sirignano, Pierluigi Cappiello, Andrea Esposito, Santi Trimarchi, Silvia Romagnoli, Andrea Padricelli, Giorgio Giudice, Adolfo Crinisio, Giovanni Di Nardo, Giuseppe Battaglia, Rosario Tringale, Salvatore De Vivo, Rita Compagna, Valerio S. Tolva, Ilenia D’Alessio, Ruggiero Curci, Simona Giovannetti, Giuseppe D’Arrigo, Giusi Basile, Dalmazio Frigerio, Gian Franco Veraldi, Luca Mezzetto, Arnaldo Ippoliti, Fabio M. Oddi, and Alberto M. Settembrini
- Subjects
chronic limb-threatening ischemia ,outcome ,sex ,age ,limb salvage ,Medicine - Abstract
Background: Identifying sex-related differences/variables associated with 30 day/1 year mortality in patients with chronic limb-threatening ischemia (CLTI). Methods: Multicenter/retrospective/observational study. A database was sent to all the Italian vascular surgeries to collect all the patients operated on for CLTI in 2019. Acute lower-limb ischemia and neuropathic-diabetic foot are not included. Follow-up: One year. Data on demographics/comorbidities, treatments/outcomes, and 30 day/1 year mortality were investigated. Results: Information on 2399 cases (69.8% men) from 36/143 (25.2%) centers. Median (IQR) age: 73 (66–80) and 79 (71–85) years for men/women, respectively (p < 0.0001). Women were more likely to be over 75 (63.2% vs. 40.1%, p = 0.0001). More men smokers (73.7% vs. 42.2%, p < 0.0001), are on hemodialysis (10.1% vs. 6.7%, p = 0.006), affected by diabetes (61.9% vs. 52.8%, p < 0.0001), dyslipidemia (69.3% vs. 61.3%, p < 0.0001), hypertension (91.8% vs. 88.5%, p = 0.011), coronaropathy (43.9% vs. 29.4%, p < 0.0001), bronchopneumopathy (37.1% vs. 25.6%, p < 0.0001), underwent more open/hybrid surgeries (37.9% vs. 28.8%, p < 0.0001), and minor amputations (22% vs. 13.7%, p < 0.0001). More women underwent endovascular revascularizations (61.6% vs. 55.2%, p = 0.004), major amputations (9.6% vs. 6.9%, p = 0.024), and obtained limb-salvage if with limited gangrene (50.8% vs. 44.9%, p = 0.017). Age > 75 (HR = 3.63, p = 0.003) is associated with 30 day mortality. Age > 75 (HR = 2.14, p < 0.0001), nephropathy (HR = 1.54, p < 0.0001), coronaropathy (HR = 1.26, p = 0.036), and infection/necrosis of the foot (dry, HR = 1.42, p = 0.040; wet, HR = 2.04, p < 0.0001) are associated with 1 year mortality. No sex-linked difference in mortality statistics. Conclusion: Women exhibit fewer comorbidities but are struck by CLTI when over 75, a factor associated with short- and mid-term mortality, explaining why mortality does not statistically differ between the sexes.
- Published
- 2023
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