Sex Differences in Mortality Risk after the First Hospitalisation with Lower Extremity Peripheral Arterial Disease

IF 5.7 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE
{"title":"Sex Differences in Mortality Risk after the First Hospitalisation with Lower Extremity Peripheral Arterial Disease","authors":"","doi":"10.1016/j.ejvs.2024.04.039","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Lower extremity peripheral arterial disease (PAD) is a severe condition that increases the risk of major adverse cardiovascular events, major adverse limb events, and all cause mortality. This study aimed to investigate the mortality risk among females and males hospitalised for the first time with lower extremity PAD.</p></div><div><h3>Methods</h3><p>Three cohorts of patients who were admitted for the first time with lower extremity PAD in 2007 – 2010, 2011 – 2014, and 2015 – 2018 were constructed. For the 2007 – 2010 and 2011 – 2014 cohorts, the 28 day, one year, and five year mortality rates were calculated, assessing survival time from date of hospital admission until date of death, end of study period, or censoring. For the 2015 – 2018 cohort, only 28 day and one year mortality were investigated due to lack of follow up data. Mortality rates of these cohorts were compared with the general population using standardised mortality rates (SMRs), and the risk of death between sexes was evaluated using Cox proportional hazards models. Cox models were adjusted for age, cardiovascular disease, and diabetes mellitus to account for potential confounding factors.</p></div><div><h3>Results</h3><p>In total, 7 950, 9 670, and 13 522 patients were included in the 2007 – 2010, 2011 – 2014, and 2015 – 2018 cohorts, respectively. Over 60% of individuals in each cohort were males. Mortality rates at 28 day and one year remained stable across all cohorts, while the five year mortality rate increased for both males and females in the 2011 – 2014 cohort. The SMRs both of females and males with PAD were significantly higher than in the general population. Multivariable regression analyses found no significant differences in mortality risk between sexes at 28 day and one year. However, the five year mortality risk was lower in females, with a hazard ratio of 0.89 (95% confidence interval [CI] 0.83 – 0.97) in the 2007 – 2010 cohort and 0.88 (95% CI 0.82 – 0.94) in the 2011 – 2014 cohort.</p></div><div><h3>Conclusion</h3><p>The five year mortality risk has increased, and females face a lower mortality risk than males. Lower extremity PAD still carries unfavourable long term consequences compared with the general population.</p></div>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":5.7000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1078588424003757/pdfft?md5=220ac45e92a9fe24ab389d7adc25c93f&pid=1-s2.0-S1078588424003757-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Vascular and Endovascular Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1078588424003757","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0

Abstract

Objective

Lower extremity peripheral arterial disease (PAD) is a severe condition that increases the risk of major adverse cardiovascular events, major adverse limb events, and all cause mortality. This study aimed to investigate the mortality risk among females and males hospitalised for the first time with lower extremity PAD.

Methods

Three cohorts of patients who were admitted for the first time with lower extremity PAD in 2007 – 2010, 2011 – 2014, and 2015 – 2018 were constructed. For the 2007 – 2010 and 2011 – 2014 cohorts, the 28 day, one year, and five year mortality rates were calculated, assessing survival time from date of hospital admission until date of death, end of study period, or censoring. For the 2015 – 2018 cohort, only 28 day and one year mortality were investigated due to lack of follow up data. Mortality rates of these cohorts were compared with the general population using standardised mortality rates (SMRs), and the risk of death between sexes was evaluated using Cox proportional hazards models. Cox models were adjusted for age, cardiovascular disease, and diabetes mellitus to account for potential confounding factors.

Results

In total, 7 950, 9 670, and 13 522 patients were included in the 2007 – 2010, 2011 – 2014, and 2015 – 2018 cohorts, respectively. Over 60% of individuals in each cohort were males. Mortality rates at 28 day and one year remained stable across all cohorts, while the five year mortality rate increased for both males and females in the 2011 – 2014 cohort. The SMRs both of females and males with PAD were significantly higher than in the general population. Multivariable regression analyses found no significant differences in mortality risk between sexes at 28 day and one year. However, the five year mortality risk was lower in females, with a hazard ratio of 0.89 (95% confidence interval [CI] 0.83 – 0.97) in the 2007 – 2010 cohort and 0.88 (95% CI 0.82 – 0.94) in the 2011 – 2014 cohort.

Conclusion

The five year mortality risk has increased, and females face a lower mortality risk than males. Lower extremity PAD still carries unfavourable long term consequences compared with the general population.

下肢外周动脉疾病患者首次住院后死亡风险的性别差异。
目的:下肢外周动脉疾病(PAD)是一种严重疾病,会增加主要不良心血管事件、主要不良肢体事件和全因死亡的风险。本研究旨在调查首次因下肢外周动脉疾病住院的女性和男性的死亡风险:2007-2010年、2011-2014年和2015-2018年首次因下肢PAD入院的患者组成了三个队列。对于 2007 - 2010 年和 2011 - 2014 年队列,计算了 28 天、1 年和 5 年的死亡率,评估了从入院日期到死亡日期、研究期结束或剔除的存活时间。对于 2015-2018 年队列,由于缺乏随访数据,只调查了 28 天和一年的死亡率。使用标准化死亡率(SMR)将这些队列的死亡率与普通人群进行比较,并使用 Cox 比例危险模型评估不同性别间的死亡风险。Cox模型对年龄、心血管疾病和糖尿病进行了调整,以考虑潜在的混杂因素:2007-2010年、2011-2014年和2015-2018年队列中分别纳入了7 950名、9 670名和13 522名患者。每个队列中超过 60% 的患者为男性。在所有队列中,28 天和一年的死亡率保持稳定,而在 2011 - 2014 年队列中,男性和女性的五年死亡率均有所上升。患有帕金森综合症的女性和男性的SMRs均明显高于普通人群。多变量回归分析发现,28天和一年的死亡率风险在性别间无显著差异。然而,女性的五年死亡风险较低,2007-2010年队列的危险比为0.89(95%置信区间[CI] 0.83 - 0.97),2011-2014年队列的危险比为0.88(95%置信区间[CI] 0.82 - 0.94):结论:五年内的死亡风险有所上升,女性的死亡风险低于男性。与普通人群相比,下肢PAD仍具有不利的长期后果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
6.80
自引率
15.80%
发文量
471
审稿时长
66 days
期刊介绍: The European Journal of Vascular and Endovascular Surgery is aimed primarily at vascular surgeons dealing with patients with arterial, venous and lymphatic diseases. Contributions are included on the diagnosis, investigation and management of these vascular disorders. Papers that consider the technical aspects of vascular surgery are encouraged, and the journal includes invited state-of-the-art articles. Reflecting the increasing importance of endovascular techniques in the management of vascular diseases and the value of closer collaboration between the vascular surgeon and the vascular radiologist, the journal has now extended its scope to encompass the growing number of contributions from this exciting field. Articles describing endovascular method and their critical evaluation are included, as well as reports on the emerging technology associated with this field.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信