Do Women Have Worse Amputation-Free Survival Than Men Following Endovascular Procedures for Peripheral Arterial Disease? An Evaluation of the California State-Wide Database

Vasc Endovascular Surg. 2015 Oct;49(7):166-74. doi: 10.1177/1538574415608269. Epub 2015 Oct 13.

Abstract

Objectives: Female gender has been shown to negatively affect the outcomes of surgical bypass for peripheral arterial disease (PAD). We examined gender-related disparities in outcomes of endovascular PAD procedures in a large population-based study.

Methods: We used discharge data from California hospitals to identify patients who had PAD interventions during 2005 to 2009. Logistic regression was used for 12-month reintervention, and Cox proportional hazard regression was used for amputation-free survival comparisons.

Results: A total of 25 635 patients had endovascular procedures (11 389 [44.4%] women). Women were more likely than men (34.5% vs 30.1%, P < .0001) to have critical limb ischemia (CLI). Twelve-month reintervention rate in women was similar to men. Amputation-free survival was better among women than men (hazard ratio 0.84, 95% confidence interval [CI] 0.76-0.93, P = .0006).

Conclusion: Despite presenting more frequently with CLI, women had better amputation-free survival than men following endovascular procedures. Future research should determine whether findings favor one type of PAD treatment modality over another for women.

Keywords: endovascular; gender; outcomes; peripheral arterial.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amputation, Surgical* / adverse effects
  • Amputation, Surgical* / mortality
  • California
  • Chi-Square Distribution
  • Databases, Factual
  • Disease-Free Survival
  • Endovascular Procedures / adverse effects*
  • Endovascular Procedures / mortality
  • Female
  • Health Status Disparities*
  • Humans
  • Kaplan-Meier Estimate
  • Limb Salvage
  • Logistic Models
  • Male
  • Middle Aged
  • Peripheral Arterial Disease / mortality
  • Peripheral Arterial Disease / therapy*
  • Proportional Hazards Models
  • Protective Factors
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Time Factors
  • Treatment Outcome