Sex-Related Differences and Factors Associated with Peri-Procedural and 1-year Mortality in Chronic Limb-Threatening Ischemia Patients from the CLIMATE Italian Registry
Authors: Martelli Eugenio , Zamboni Matilde , Sotgiu Giovanni , Saderi Laura , Federici Massimo , Sangiorgi Giuseppe Massimo , Puci Mariangela Valentina , Martelli Allegra Rosa , 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 Michelino , Palmieri Armado , 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 Pietro , Maiorano Maurizio , Bracale Umberto Marcello , Panagrosso Marco , Monaco Mario , Giordano Giovanni , Natalicchio Giuseppe , Biello Antonella , Celoria Giovanni Maria , 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 Stefano , D'Alessio Ilenia , Curci Ruggiero , Giovannetti Simona , D'Arrigo Giuseppe , Basile Giusi , Frigerio Dalmazio , Veraldi Gian Franco , Mezzetto Luca , Ippoliti Arnaldo , Oddi Fabio Massimo , Settembrini Alberto Maria 
Published: December 2022

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. Database sent to all-the-Italian vascular surgeries to collect all-the&not;-patients operated for CLTI in 2019. Acute lower-limb ischemia and neuropathic-diabetic foot not included. Follow-up: 1-year. Data on demographics/comorbidities, treatments/outcome, and 30-day/1-year mortality 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) yrs for men/women, respectively (p&lt;.0001). Women more over-75 (63.2%vs40.1%, p=.0001). More men smokers (73.7%vs42.2%, p&lt;.0001), on hemodialysis (10.1%vs6.7%, p=.006), affected by diabetes (61.9%vs52.8%, p&lt;.0001), dyslipidemia (69.3%vs61.3%, p&lt;.0001), hypertension (91.8%vs88.5%, p=.011), coronaropathy (43.9%vs29.4%, p&lt;.0001), bronchopneumopathy (37.1%vs25.6%, p&lt;.0001), underwent more open/hybrid surgeries (37.9%vs28.8%, p&lt;.0001), and minor amputations (22%vs13.7%, p&lt;.0001). More women underwent endovascular revascularizations (61.6%vs55.2%, p=.004), major amputations (9.6%vs6.9%, p=.024), and obtained limb-salvage if with limited gangrene (50.8%vs44.9%, p=.017). Age &gt;75 (HR3.63, p=.003) associated with 30-day mortality. Age &gt;75 (HR2.14, p&lt;.0001), nephropathy (HR1.54, p&lt;.0001), coronaropathy (HR1.26, p=.036), infection/necrosis of the foot (dry, HR1.42, p=.040; wet, HR2.04, p&lt;.0001) 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/mid-term mortality, explaining why mortality doesn&rsquo;t statistically differ between the sexes.