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 Massimo Sangiorgi; Mariangela Valentina Puci; Allegra Rosa 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 Michelino Fiore; Armado 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; Pietro Modugno; Maurizio Maiorano; Umberto Marcello Bracale; Marco Panagrosso; Mario Monaco; Giovanni Giordano; Giuseppe Natalicchio; Antonella Biello; Giovanni Maria 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 Stefano Tolva; Ilenia D'Alessio; Ruggiero Curci; Simona Giovannetti; Giuseppe D'Arrigo; Giusi Basile; Dalmazio Frigerio; Gian Franco Veraldi; Luca Mezzetto; Arnaldo Ippoliti; Fabio Massimo Oddi; Alberto Maria Settembrini

doi:10.20944/preprints202212.0152.v1

A peer-reviewed article of this Preprint also exists.

Martelli, E.; Zamboni, M.; Sotgiu, G.; Saderi, L.; Federici, M.; Sangiorgi, G.M.; Puci, M.V.; Martelli, A.R.; Messina, T.; Frigatti, P.; Borrelli, M.P.; Ruotolo, C.; Ficarelli, I.; Rubino, P.; Pezzo, F.; Carbonari, L.; Angelini, A.; Galeazzi, E.; Pinto, L.C.D.; Fiore, F.M.; Palmieri, A.; Ventoruzzo, G.; Mazzitelli, G.; Ragni, F.; Bozzani, A.; Forliti, E.; Castagno, C.; Volpe, P.; Massara, M.; Moniaci, D.; Pagliasso, E.; Peretti, T.; Ferrari, M.; Troisi, N.; Modugno, P.; Maiorano, M.; Bracale, U.M.; Panagrosso, M.; Monaco, M.; Giordano, G.; Natalicchio, G.; Biello, A.; Celoria, G.M.; Amico, A.; Di Bartolo, M.; Martelli, M.; Munaó, R.; Razzano, D.; Colacchio, G.; Bussetti, F.; Lanza, G.; Cardini, A.; Di Benedetto, B.; De Laurentis, M.; Taurino, M.; Sirignano, P.; Cappiello, P.; Esposito, A.; Trimarchi, S.; Romagnoli, S.; Padricelli, A.; Giudice, G.; Crinisio, A.; Di Nardo, G.; Battaglia, G.; Tringale, R.; De Vivo, S.; Compagna, R.; Tolva, V.S.; D’Alessio, I.; Curci, R.; Giovannetti, S.; D’Arrigo, G.; Basile, G.; Frigerio, D.; Veraldi, G.F.; Mezzetto, L.; Ippoliti, A.; Oddi, F.M.; Settembrini, A.M. Sex-Related Differences and Factors Associated with Peri-Procedural and 1 Year Mortality in Chronic Limb-Threatening Ischemia Patients from the CLIMATE Italian Registry. J. Pers. Med. 2023, 13, 316. Martelli, E.; Zamboni, M.; Sotgiu, G.; Saderi, L.; Federici, M.; Sangiorgi, G.M.; Puci, M.V.; Martelli, A.R.; Messina, T.; Frigatti, P.; Borrelli, M.P.; Ruotolo, C.; Ficarelli, I.; Rubino, P.; Pezzo, F.; Carbonari, L.; Angelini, A.; Galeazzi, E.; Pinto, L.C.D.; Fiore, F.M.; Palmieri, A.; Ventoruzzo, G.; Mazzitelli, G.; Ragni, F.; Bozzani, A.; Forliti, E.; Castagno, C.; Volpe, P.; Massara, M.; Moniaci, D.; Pagliasso, E.; Peretti, T.; Ferrari, M.; Troisi, N.; Modugno, P.; Maiorano, M.; Bracale, U.M.; Panagrosso, M.; Monaco, M.; Giordano, G.; Natalicchio, G.; Biello, A.; Celoria, G.M.; Amico, A.; Di Bartolo, M.; Martelli, M.; Munaó, R.; Razzano, D.; Colacchio, G.; Bussetti, F.; Lanza, G.; Cardini, A.; Di Benedetto, B.; De Laurentis, M.; Taurino, M.; Sirignano, P.; Cappiello, P.; Esposito, A.; Trimarchi, S.; Romagnoli, S.; Padricelli, A.; Giudice, G.; Crinisio, A.; Di Nardo, G.; Battaglia, G.; Tringale, R.; De Vivo, S.; Compagna, R.; Tolva, V.S.; D’Alessio, I.; Curci, R.; Giovannetti, S.; D’Arrigo, G.; Basile, G.; Frigerio, D.; Veraldi, G.F.; Mezzetto, L.; Ippoliti, A.; Oddi, F.M.; Settembrini, A.M. Sex-Related Differences and Factors Associated with Peri-Procedural and 1 Year Mortality in Chronic Limb-Threatening Ischemia Patients from the CLIMATE Italian Registry. J. Pers. Med. 2023, 13, 316.

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. Database sent to all-the-Italian vascular surgeries to collect all-the¬-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<.0001). Women more over-75 (63.2%vs40.1%, p=.0001). More men smokers (73.7%vs42.2%, p<.0001), on hemodialysis (10.1%vs6.7%, p=.006), affected by diabetes (61.9%vs52.8%, p<.0001), dyslipidemia (69.3%vs61.3%, p<.0001), hypertension (91.8%vs88.5%, p=.011), coronaropathy (43.9%vs29.4%, p<.0001), bronchopneumopathy (37.1%vs25.6%, p<.0001), underwent more open/hybrid surgeries (37.9%vs28.8%, p<.0001), and minor amputations (22%vs13.7%, p<.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 >75 (HR3.63, p=.003) associated with 30-day mortality. Age >75 (HR2.14, p<.0001), nephropathy (HR1.54, p<.0001), coronaropathy (HR1.26, p=.036), infection/necrosis of the foot (dry, HR1.42, p=.040; wet, HR2.04, p<.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’t statistically differ between the sexes.

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

Abstract

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