Manara - Qatar Research Repository
Browse
1/1
2 files

Sex Differences in Trends and In‐Hospital Outcomes Among Patients With Critical Limb Ischemia: A Nationwide Analysis

Download all (879.66 kB)
journal contribution
submitted on 2024-05-07, 11:43 and posted on 2024-05-07, 11:44 authored by Ayman Elbadawi, Kirolos Barssoum, Michael Megaly, Devesh Rai, Ahmed Elsherbeeny, Hend Mansoor, Mehdi H. Shishehbor, Ahmed Abdel‐Latif, Martha Gulati, Islam Y. Elgendy

Background

Critical limb ischemia (CLI) represents the most severe form of peripheral artery disease and is associated with significant mortality and morbidity. Contemporary data comparing the sex differences in trends, revascularization strategies, and in‐hospital outcomes among patients with CLI are scarce.

Methods and Results

Using the National Inpatient Sample database years 2002 to 2015, we identified hospitalizations for CLI. Temporal trends for hospitalizations for CLI were evaluated. The differences in demographics, revascularization, and in‐hospital outcomes between both sexes were compared. Among 2 400 778 CLI hospitalizations, 43.6% were women. Women were older and had a higher prevalence of obesity, hypertension, heart failure, and prior stroke. Women were also less likely to receive any revascularization (34.7% versus 35.4%, P <0.001), but the trends of revascularization have been increasing among both sexes. Revascularization was associated with lower in‐hospital mortality among women (adjusted odds ratio [OR], 0.76; 95% CI, 0.71–0.81) and men (adjusted OR, 0.69; 95% CI, 0.65–0.73). On multivariable analysis adjusting for patient‐ and hospital‐related characteristics as well as revascularization, women had a higher incidence of in‐hospital mortality, postoperative hemorrhage, need for blood transfusion, postoperative infection, ischemic stroke, and discharge to facilities compared with men.

Conclusions

In this nationwide contemporary analysis of CLI hospitalizations, women were older and less likely to undergo revascularization. Women had a higher incidence of in‐hospital mortality and bleeding complications compared with men. Sex‐specific studies and interventions are needed to minimize these gaps among this high‐risk population.

Other Information

Published in: Journal of the American Heart Association
License: http://creativecommons.org/licenses/by-ncnd/4.0/
See article on publisher's website: https://dx.doi.org/10.1161/jaha.121.022043

History

Language

  • English

Publisher

Wolters Kluwer

Publication Year

  • 2021

License statement

This Item is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License

Institution affiliated with

  • Hamad Bin Khalifa University
  • College of Health and Life Sciences - HBKU
  • Weill Cornell Medicine - Qatar

Methodology

Using the National Inpatient Sample database years 2002 to 2015, we identified hospitalizations for CLI. Temporal trends for hospitalizations for CLI were evaluated. The differences in demographics, revascularization, and in‐hospital outcomes between both sexes were compared. Among 2 400 778 CLI hospitalizations, 43.6% were women. Women were older and had a higher prevalence of obesity, hypertension, heart failure, and prior stroke. Women were also less likely to receive any revascularization (34.7% versus 35.4%, P<0.001), but the trends of revascularization have been increasing among both sexes. Revascularization was associated with lower in‐hospital mortality among women (adjusted odds ratio [OR], 0.76; 95% CI, 0.71–0.81) and men (adjusted OR, 0.69; 95% CI, 0.65–0.73). On multivariable analysis adjusting for patient‐ and hospital‐related characteristics as well as revascularization, women had a higher incidence of in‐hospital mortality, postoperative hemorrhage, need for blood transfusion, postoperative infection, ischemic stroke, and discharge to facilities compared with men.

Usage metrics

    College of Health and Life Sciences - HBKU

    Categories

    Keywords

    critical limb ischemiamortalityrevascularizationsexwomen

    Licence

    CC BY-NC-ND 4.0

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC