Analysis of gender-related differences in lower extremity peripheral arterial disease

被引:116
作者
Egorova, Natalia [2 ]
Vouvouka, Ageliki G. [1 ]
Quin, Jacquelyn [3 ]
Guillerme, Stephanie [2 ]
Moskowitz, Alan [2 ]
Marin, Michael
Faries, Peter L.
机构
[1] Mt Sinai Med Ctr, Div Vasc Surg, Sch Med, New York, NY 10029 USA
[2] Mt Sinai Med Ctr, Dept Hlth Evidence & Policy, New York, NY 10029 USA
[3] Roxbury VAMC, Surg Serv, Boston, MA USA
关键词
ABDOMINAL AORTIC-ANEURYSM; UNITED-STATES; MORTALITY-RATES; BYPASS-SURGERY; RISK-FACTORS; WOMEN; PREVALENCE; OUTCOMES; REPAIR; MEN;
D O I
10.1016/j.jvs.2009.09.006
中图分类号
R61 [外科手术学];
学科分类号
摘要
Introduction: Gender-related differences continue to challenge the management of lower extremity (LE) peripheral arterial disease (PAD) in women. We analyzed the time-trends ill hospital care of such differences. Methods: Data for patients with PAD from New York, New Jersey, and Florida state hospital inpatient discharge databases (1998-2007) were analyzed using univariate and multivariate regression analyses. Results: The 2.4 million PAD-related inpatient discharge records analyzed showed a slight decrease of inpatient procedures for both genders. Compared with men, women had 18% to 27% fewer PAD and 33% to 49% fewer vascular procedural hospitalizations (P<.0001). They were persistently more likely than men to be admitted emergently (56% vs 51% in 1998 and 57% vs 53% in 2007) and discharged to a nursing home. During the study period, the amputation rate declined by 36% in women and 21% in men with PAD, and similarly, open procedures decreased by 36% and 30%. Endovascular procedures, however, increased by 150% in women and 144% in men. Procedural mortality was 4.95% vs 4.37% for men (P<.0001). Female mortality rates were persistently higher after amputations (9.89% vs 8.90%, P<.0001), open (5.49% vs 4.00%, P<.0001), and endovascular procedures (2.87% vs 2.10%, P<.0001). Time trends showed improved mortality for men and women, with a stable difference between the two. Conclusion: The analysis of representative state administrative databases of inpatient care records demonstrated improvements in mortality and amputation rates over time. However, a gender-related disparity in PAD outcomes remains that merits further investigation. (J Vasc Surg 20 10;51:372-9.)
引用
收藏
页码:372 / 379
页数:8
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