Journal of Personalized Medicine (Feb 2023)

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,
  • 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,
  • Alberto M. Settembrini

DOI
https://doi.org/10.3390/jpm13020316
Journal volume & issue
Vol. 13, no. 2
p. 316

Abstract

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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 p = 0.0001). More men smokers (73.7% vs. 42.2%, p p = 0.006), affected by diabetes (61.9% vs. 52.8%, p p p = 0.011), coronaropathy (43.9% vs. 29.4%, p p p p 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 p 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.

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