Sex-Related Differences and Factors Associated with Peri-Procedural and 1 Year Mortality in Chronic Limb-Threatening Ischemia Patients from the CLIMATE Italian Registry-Reference-Cited by-同舟云学术

Sex-Related Differences and Factors Associated with Peri-Procedural and 1 Year Mortality in Chronic Limb-Threatening Ischemia Patients from the CLIMATE Italian Registry

Published:2023-02-11 Issue:2 Volume:13 Page:316
ISSN:2075-4426
Container-title:Journal of Personalized Medicine
language:en
Short-container-title:JPM

Author:

Martelli Eugenio¹²³^ORCID,Zamboni Matilde⁴^ORCID,Sotgiu Giovanni⁵^ORCID,Saderi Laura⁵^ORCID,Federici Massimo⁶,Sangiorgi Giuseppe M.⁷^ORCID,Puci Mariangela V.⁵^ORCID,Martelli Allegra R.⁸,Messina Teresa⁹,Frigatti Paolo¹⁰^ORCID,Borrelli Maria Pia¹⁰,Ruotolo Carlo¹¹,Ficarelli Ilaria¹¹,Rubino Paolo¹²,Pezzo Francesco¹²,Carbonari Luciano¹³,Angelini Andrea¹³,Galeazzi Edoardo¹⁴,Di Pinto Luca Calia¹⁴,Fiore Franco M.¹⁵,Palmieri Armando¹⁵,Ventoruzzo Giorgio¹⁶,Mazzitelli Giulia¹⁶,Ragni Franco¹⁷,Bozzani Antonio¹⁷^ORCID,Forliti Enzo¹⁸,Castagno Claudio¹⁸,Volpe Pietro¹⁹,Massara Mafalda¹⁹,Moniaci Diego²⁰^ORCID,Pagliasso Elisa²⁰,Peretti Tania²⁰,Ferrari Mauro²¹,Troisi Nicola²¹^ORCID,Modugno Piero²²,Maiorano Maurizio²²,Bracale Umberto M.²³^ORCID,Panagrosso Marco²³,Monaco Mario²⁴²⁵,Giordano Giovanni²⁵,Natalicchio Giuseppe²⁶,Biello Antonella²⁶,Celoria Giovanni M.²⁷,Amico Alessio²⁷,Di Bartolo Mauro²⁷^ORCID,Martelli Massimiliano²⁸,Munaó Roberta²⁸,Razzano Davide²⁹,Colacchio Giovanni³⁰^ORCID,Bussetti Francesco³⁰,Lanza Gaetano³¹,Cardini Antonio³¹,Di Benedetto Bartolomeo³²,De Laurentis Mario³²,Taurino Maurizio³³³⁴^ORCID,Sirignano Pasqualino¹³⁴^ORCID,Cappiello Pierluigi³⁵,Esposito Andrea³⁵,Trimarchi Santi³⁶³⁷,Romagnoli Silvia³⁷,Padricelli Andrea³,Giudice Giorgio³,Crinisio Adolfo³⁸,Di Nardo Giovanni³⁸,Battaglia Giuseppe³⁹,Tringale Rosario³⁹,De Vivo Salvatore⁴⁰,Compagna Rita⁴⁰,Tolva Valerio S.⁴¹^ORCID,D’Alessio Ilenia⁴¹,Curci Ruggiero⁴²,Giovannetti Simona⁴²,D’Arrigo Giuseppe⁴³,Basile Giusi⁴³,Frigerio Dalmazio⁴⁴,Veraldi Gian Franco⁴⁵,Mezzetto Luca⁴⁵^ORCID,Ippoliti Arnaldo⁷,Oddi Fabio M.⁷^ORCID,Settembrini Alberto M.³⁷^ORCID

Affiliation:

1. Department of General and Specialist Surgery Paride Stefanini, Faculty of Pharmacy and Medicine, Sapienza University of Rome, 155 viale del Policlinico, 00161 Rome, Italy

2. Medicine and Surgery School of Medicine, Saint Camillus International University of Health Sciences, 8 via di Sant’Alessandro, 00131 Rome, Italy

3. Division of Vascular Surgery, Department of Cardiovascular Sciences, S. Anna and S. Sebastiano Hospital, via F. Palasciano, 81100 Caserta, Italy

4. Division of Vascular Surgery, Saint Martin Hospital, 22 viale Europa, 32100 Belluno, Italy

5. Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, viale San Pietro, 07100 Sassari, Italy

6. Department of Systems Medicine, University of Rome Tor Vergata, 1 viale Montpellier, 00133 Rome, Italy

7. Department of Biomedicine and Prevention, University of Rome Tor Vergata, 1 viale Montpellier, 00133 Rome, Italy

8. Medicine and Surgery School of Medicine, Campus Bio-Medico University of Rome, 21 via À. del Portillo, 00128 Rome, Italy

9. Division of Anesthesia and Intensive Care of Organ Transplants, Umberto I Polyclinic University Hospital, 155 viale del Policlinico, 00161 Rome, Italy

10. Divisions of Vascular Surgery, S. Maria Misericordia University Hospital, 15 Piazzale Santa Maria della Misericordia, 33100 Udine, Italy

11. Divisions of Vascular Surgery, Cardarelli Hospital, 9 Via A. Cardarelli, 80131 Naples, Italy

12. Divisions of Vascular Surgery, Pugliese Ciaccio Hospital, 83 viale Pio X, 88100 Catanzaro, Italy

13. Divisions of Vascular Surgery, Riuniti University Hospitals, 71 via Conca, Torrette (AN), 60126 Ancona, Italy

14. Divisions of Vascular Surgery, Treviso Hospital, 1 piazzale del’Ospedale, 31100 Treviso, Italy

15. Divisions of Vascular Surgery, SS. Annunziata Hospital, 31 via dei Vestini, 66100 Chieti, Italy

16. Divisions of Vascular Surgery, San Donato Hospital, 20 via Pietro Nenni, 52100 Arezzo, Italy

17. Divisions of Vascular Surgery, San Matteo Polyclinic, 19 viale Camillo Golgi, 27100 Pavia, Italy

18. Divisions of Vascular Surgery, Infermi Hospital, Via dei Ponderanesi 2, 13875 Ponderano, Italy

19. Divisions of Vascular Surgery, Bianchi-Melacrino-Morelli Hospital, 21 via G. Melacrino, 89124 Reggio di Calabria, Italy

20. Divisions of Vascular Surgery, San Giovanni Bosco Hospital, 3 piazza del Donatore di Sangue, 10154 Turin, Italy

21. Divisions of Vascular Surgery, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 2 via Paradisa, 56124 Pisa, Italy

22. Divisions of Vascular Surgery, Gemelli Molise Hospital, 1 largo A. Gemelli, 86100 Campobasso, Italy

23. Divisions of Vascular Surgery, Federico II Polyclinic, Department of Public Health and Residency Program in Vascular Surgery, University of Naples Federico II, 5 via S. Pansini, 80131 Naples, Italy

24. Divisions of Vascular Surgery, Pineta Grande Hospital, Km. 30 via Domitiana, 81030 Castelvolturno, Italy

25. Divisions of Vascular Surgery, Sanatrix Clinic, 31 via S. Domenico, 80127 Naples, Italy

26. Divisions of Vascular Surgery, Venere Hospital, 1 via Ospedale di Venere, 70131 Bari, Italy

27. Divisions of Vascular Surgery, Sant’Andrea Hospital, 197 via Vittorio Veneto, 19121 La Spezia, Italy

28. Divisions of Vascular Surgery, MultiMedica Hospital, 300 via Milenese, 20099 Sesto San Giovanni, Italy

29. Divisions of Vascular Surgery, San Pio Hospital, 1 via dell’angelo, 82100 Benevento, Italy

30. Divisions of Vascular Surgery, F.Miulli Hospital, Strada Prov. 127 Acquaviva-Santeramo Km. 4, 70021 Acquaviva delle Fonti, Italy

31. Divisions of Vascular Surgery, Multimedica Hospital, 70 viale Piemonte, 21053 Castellanza, Italy

32. Divisions of Vascular Surgery, Monaldi Hospital, via L. Bianchi, 84100 Naples, Italy

33. Divisions of Vascular Surgery, Department of Molecular and Clinical Medicine, Sapienza University of Rome, Giorgio Nicola Papanicolau, 00189 Rome, Italy

34. Divisions of Vascular Surgery, Sant’Andrea University Hospital, 1035/1039 via di Grottarossa, 00189 Rome, Italy

35. Divisions of Vascular Surgery, San Carlo Hospital, via Potito Petrone, 85100 Potenza, Italy

36. Divisions of Vascular Surgery, Department of Clinical and Community Sciences, University of Milan, 19 via della Commenda, 20122 Milan, Italy

37. Divisions of Vascular Surgery, Maggiore Polyclinic Hospital Ca’ Granda IRCCS and Foundation, 35 via Francesco Sforza, 20122 Milan, Italy

38. Divisions of Vascular Surgery, Salus Clinic, 4 via F. Confalonieri, 84091 Battipaglia, Italy

39. Divisions of Vascular Surgery, San Marco Hospital, viale Carlo Azeglio Ciampi, 95121 Catania, Italy

40. Divisions of Vascular Surgery, Pellegrini Hospital, 41 via Portamedina alla Pignasecca, 80134 Naples, Italy

41. Divisions of Vascular Surgery, Niguarda Hospital, Piazza dell’Ospedale Maggiore 3, 20161 Milan, Italy

42. Divisions of Vascular Surgery, Maggiore Hospital, 10 Piazza Ospitale, 26900 Lodi, Italy

43. Divisions of Vascular Surgery, Garibaldi-Nesima Hospital, 636 via Palermo, 95122 Catania, Italy

44. Divisions of Vascular Surgery, Vimercate Hospital, 10 via Cosma e Damiano, 20871 Vimercate, Italy

45. Divisions of Vascular Surgery, University Hospital Pietro Confortini, 1 Piazzale Aristide Stefani, 37126 Verona, Italy

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.

Publisher

MDPI AG

Subject

Medicine (miscellaneous)

Link

https://www.mdpi.com/2075-4426/13/2/316/pdf

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