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.
Sex-Related Differences and Factors Associated with Peri-Procedural and 1 Year Mortality in Chronic Limb-Threatening Ischemia Patients from the CLIMATE Italian Registry / Martelli, Eugenio; Zamboni, Matilde; Sotgiu, Giovanni; Saderi, Laura; Federici, Massimo; M Sangiorgi, Giuseppe; V Puci, Mariangela; R Martelli, Allegra; Messina, Teresa; Frigatti, Paolo; Pia Borrelli, Maria; Ruotolo, Carlo; Ficarelli, Ilaria; Rubino, Paolo; Pezzo, Francesco; Carbonari, Luciano; Angelini, Andrea; Galeazzi, Edoardo; Calia Di Pinto, Luca; M Fiore, Franco; Palmieri, Armando; Ventoruzzo, Giorgio; Mazzitelli, Giulia; Ragni, Franco; Bozzani, Antonio; Forliti, Enzo; Castagno, Claudio; Volpe, Pietro; Massara, Mafalda; Moniaci, Diego; Pagliasso, Elisa; Peretti, Tania; Ferrari, Mauro; Troisi, Nicola; Modugno, Piero; Maiorano, Maurizio; M Bracale, Umberto; Panagrosso, Marco; Monaco, Mario; Giordano, Giovanni; Natalicchio, Giuseppe; Biello, Antonella; M Celoria, Giovanni; Amico, Alessio; Di Bartolo, Mauro; Martelli, Massimiliano; Munaò, Roberta; Razzano, Davide; Colacchio, Giovanni; Bussetti, Francesco; Lanza, Gaetano; Cardini, Antonio; Di Benedetto, Bartolomeo; De Laurentis, Mario; Taurino, Maurizio; Sirignano, Pasqualino; Cappiello, Pierluigi; Esposito, Andrea; Trimarchi, Santi; Romagnoli, Silvia; Padricelli, Andrea; Giudice, Giorgio; Crinisio, Adolfo; Di Nard, Giovanni; Battaglia, Giuseppe; Tringale, Rosario; De Vivo, Salvatore; Compagna, Rita; S Tolva, Valerio; D'Alessio, Ilenia; Curci, Ruggiero; Giovannetti, Simona; D'Arrigo, Giuseppe; Basile, Giusi; Frigerio, Dalmazio; Franco Veraldi, Gian; Mezzetto, Luca; Ippoliti, Arnaldo; M Oddi, Fabio; M Settembrini, Alberto. - In: JOURNAL OF PERSONALIZED MEDICINE. - ISSN 2075-4426. - 13:2(2023), pp. 1-14. [10.3390/jpm13020316]
Sex-Related Differences and Factors Associated with Peri-Procedural and 1 Year Mortality in Chronic Limb-Threatening Ischemia Patients from the CLIMATE Italian Registry
Eugenio Martelli
Primo
Conceptualization
;Antonella Biello;Maurizio TaurinoMembro del Collaboration Group
;Pasqualino SirignanoMembro del Collaboration Group
;Giovanni Di Nard;
2023
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.| File | Dimensione | Formato | |
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