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

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 a...

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Autores principales:	Ayman Elbadawi, Kirolos Barssoum, Michael Megaly, Devesh Rai, Ahmed Elsherbeeny, Hend Mansoor, Mehdi H. Shishehbor, Ahmed Abdel‐Latif, Martha Gulati, Islam Y. Elgendy
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	critical limb ischemia mortality revascularization sex women Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/fd05b03369a841318125b4f5309fb810
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spelling	oai:doaj.org-article:fd05b03369a841318125b4f5309fb8102021-11-23T11:36:34ZSex Differences in Trends and In‐Hospital Outcomes Among Patients With Critical Limb Ischemia: A Nationwide Analysis10.1161/JAHA.121.0220432047-9980https://doaj.org/article/fd05b03369a841318125b4f5309fb8102021-09-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.121.022043https://doaj.org/toc/2047-9980Background 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.Ayman ElbadawiKirolos BarssoumMichael MegalyDevesh RaiAhmed ElsherbeenyHend MansoorMehdi H. ShishehborAhmed Abdel‐LatifMartha GulatiIslam Y. ElgendyWileyarticlecritical limb ischemiamortalityrevascularizationsexwomenDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	critical limb ischemia mortality revascularization sex women Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	critical limb ischemia mortality revascularization sex women Diseases of the circulatory (Cardiovascular) system RC666-701 Ayman Elbadawi Kirolos Barssoum Michael Megaly Devesh Rai Ahmed Elsherbeeny Hend Mansoor Mehdi H. Shishehbor Ahmed Abdel‐Latif Martha Gulati Islam Y. Elgendy Sex Differences in Trends and In‐Hospital Outcomes Among Patients With Critical Limb Ischemia: A Nationwide Analysis
description	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.
format	article
author	Ayman Elbadawi Kirolos Barssoum Michael Megaly Devesh Rai Ahmed Elsherbeeny Hend Mansoor Mehdi H. Shishehbor Ahmed Abdel‐Latif Martha Gulati Islam Y. Elgendy
author_facet	Ayman Elbadawi Kirolos Barssoum Michael Megaly Devesh Rai Ahmed Elsherbeeny Hend Mansoor Mehdi H. Shishehbor Ahmed Abdel‐Latif Martha Gulati Islam Y. Elgendy
author_sort	Ayman Elbadawi
title	Sex Differences in Trends and In‐Hospital Outcomes Among Patients With Critical Limb Ischemia: A Nationwide Analysis
title_short	Sex Differences in Trends and In‐Hospital Outcomes Among Patients With Critical Limb Ischemia: A Nationwide Analysis
title_full	Sex Differences in Trends and In‐Hospital Outcomes Among Patients With Critical Limb Ischemia: A Nationwide Analysis
title_fullStr	Sex Differences in Trends and In‐Hospital Outcomes Among Patients With Critical Limb Ischemia: A Nationwide Analysis
title_full_unstemmed	Sex Differences in Trends and In‐Hospital Outcomes Among Patients With Critical Limb Ischemia: A Nationwide Analysis
title_sort	sex differences in trends and in‐hospital outcomes among patients with critical limb ischemia: a nationwide analysis
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/fd05b03369a841318125b4f5309fb810
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Sex Differences in Trends and In‐Hospital Outcomes Among Patients With Critical Limb Ischemia: A Nationwide Analysis

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