Martelli Eugenio, Zamboni Matilde, Sotgiu Giovanni, Saderi Laura, Federici Massimo, Sangiorgi Giuseppe M, Puci Mariangela V, Martelli Allegra R, Messina Teresa, Frigatti Paolo, Borrelli Maria Pia, Ruotolo Carlo, Ficarelli Ilaria, Rubino Paolo, Pezzo Francesco, Carbonari Luciano, Angelini Andrea, Galeazzi Edoardo, Di Pinto Luca Calia, Fiore Franco M, 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, Bracale Umberto M, Panagrosso Marco, Monaco Mario, Giordano Giovanni, Natalicchio Giuseppe, Biello Antonella, Celoria Giovanni M, Amico Alessio, Di Bartolo Mauro, Martelli Massimiliano, Munaó 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 Nardo Giovanni, Battaglia Giuseppe, Tringale Rosario, De Vivo Salvatore, Compagna Rita, Tolva Valerio S, D'Alessio Ilenia, Curci Ruggiero, Giovannetti Simona, D'Arrigo Giuseppe, Basile Giusi, Frigerio Dalmazio, Veraldi Gian Franco, Mezzetto Luca, Ippoliti Arnaldo, Oddi Fabio M, Settembrini Alberto M
Department of General and Specialist Surgery Paride Stefanini, Faculty of Pharmacy and Medicine, Sapienza University of Rome, 155 viale del Policlinico, 00161 Rome, Italy.
Medicine and Surgery School of Medicine, Saint Camillus International University of Health Sciences, 8 via di Sant'Alessandro, 00131 Rome, Italy.
J Pers Med. 2023 Feb 11;13(2):316. doi: 10.3390/jpm13020316.
Identifying sex-related differences/variables associated with 30 day/1 year mortality in patients with chronic limb-threatening ischemia (CLTI).
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.
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 ( < 0.0001). Women were more likely to be over 75 (63.2% vs. 40.1%, = 0.0001). More men smokers (73.7% vs. 42.2%, < 0.0001), are on hemodialysis (10.1% vs. 6.7%, = 0.006), affected by diabetes (61.9% vs. 52.8%, < 0.0001), dyslipidemia (69.3% vs. 61.3%, < 0.0001), hypertension (91.8% vs. 88.5%, = 0.011), coronaropathy (43.9% vs. 29.4%, < 0.0001), bronchopneumopathy (37.1% vs. 25.6%, < 0.0001), underwent more open/hybrid surgeries (37.9% vs. 28.8%, < 0.0001), and minor amputations (22% vs. 13.7%, < 0.0001). More women underwent endovascular revascularizations (61.6% vs. 55.2%, = 0.004), major amputations (9.6% vs. 6.9%, = 0.024), and obtained limb-salvage if with limited gangrene (50.8% vs. 44.9%, = 0.017). Age > 75 (HR = 3.63, = 0.003) is associated with 30 day mortality. Age > 75 (HR = 2.14, < 0.0001), nephropathy (HR = 1.54, < 0.0001), coronaropathy (HR = 1.26, = 0.036), and infection/necrosis of the foot (dry, HR = 1.42, = 0.040; wet, HR = 2.04, < 0.0001) are associated with 1 year mortality. No sex-linked difference in mortality statistics.
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.
确定与慢性肢体威胁性缺血（CLTI）患者30天/1年死亡率相关的性别差异/变量。
多中心/回顾性/观察性研究。向所有意大利血管外科发送一个数据库，以收集2019年接受CLTI手术的所有患者的信息。不包括急性下肢缺血和神经性糖尿病足。
一年。调查了人口统计学/合并症、治疗/结果以及30天/1年死亡率的数据。
来自36/143（25.2%）个中心的2399例病例的信息（69.8%为男性）。男性/女性的年龄中位数（IQR）分别为73（66 - 80）岁和79（71 - 85）岁（<0.0001）。女性超过75岁的可能性更大（63.2%对40.1%，=0.0001）。男性吸烟者更多（73.7%对42.2%，<0.0001），接受血液透析的更多（10.1%对6.7%，=0.006），患糖尿病的更多（61.9%对52.8%，<0.0001），患血脂异常的更多（69.3%对61.3%，<0.0001），患高血压的更多（91.8%对88.5%，=0.011），患冠状动脉病的更多（43.9%对29.4%，<0.0001），患支气管肺病的更多（37.1%对25.6%，<0.0001），接受更多的开放/杂交手术（37.9%对28.8%，<0.0001），以及小截肢手术（22%对13.7%，<0.0001）。女性接受血管腔内血运重建术的更多（61.6%对55.2%，=0.004），接受大截肢手术的更多（9.6%对6.9%，=0.024），并且如果有局限性坏疽则肢体挽救率更高（50.8%对44.9%，=0.017）。年龄>75岁（HR = 3.63，=0.003）与30天死亡率相关。年龄>75岁（HR = 2.14，<0.0001）、肾病（HR = 1.54，<0.0001）、冠状动脉病（HR = 1.26，=0.036）以及足部感染/坏死（干性，HR = 1.42，=0.040；湿性，HR = 2.04，<0.0001）与1年死亡率相关。死亡率统计中无性别相关差异。
女性合并症较少，但75岁以上时易患CLTI，这是一个与短期和中期死亡率相关的因素，解释了为何两性之间死亡率在统计学上无差异。
