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Short-term mortality similar for women, men after endovascular treatment of PAD
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After undergoing endovascular procedures for peripheral artery disease, the rates of in-hospital mortality did not differ significantly between men and women, according to published data.
However, compared with men, women tended to be older and have more comorbidities upon presentation. They were also more likely to undergo emergent or urgent procedures than men.
The researchers analyzed data from the National Inpatient Sample database from 2012 to 2014. Of the 62,444 patients with PAD who underwent interventional procedures, 57% were men and 43% were women. After performing propensity score matching, 25,758 patients were included in each group.
Results revealed no significant difference in the primary outcome of in-hospital mortality between men and women (2.3% vs. 2.4%), but men had higher rates of complications, including acute renal failure (14% vs. 12.5%; P .001), gangrene (4.2% vs. 3.6%; P = .002), infection (12.4% vs. 8.7%; P .001), non-major amputation (11.3% vs. 7.1%; P .001) and a composite of all complications (36% vs. 35.1%; P = .039). However, more women experienced blood loss requiring transfusion (14.9% vs. 11.9%; P .001).
The researchers also found no significant differences between men and women in vascular injury requiring surgery (12.5% for both) and length of hospital stay (7.1 days for both). Nevertheless, the median cost associated with hospitalization was higher for men ($23,112 vs. $21,851; P .001), which was potentially due to the higher complication rates, the researchers noted.
The mean age upon presentation was higher in women compared with men (69.9 vs. 67.5 years; P .0001). The rate of procedures also increased in women after age 60 years and was higher than men after age 80 years. Additionally, before endovascular treatment, more women than men had a Charlson comorbidity index score of at least 2 (75.4% vs. 68.5%; P .0001).
These findings suggest that women with PAD should be treated as aggressively as men, according to the researchers.
“Future observational studies should be directed toward gender-based outcomes treated with endovascular approach including more variables such as anatomic location of the lesion, presence of chronic limb ischemia and prior medication use,” the researchers wrote. “Additionally, our findings are only hypothesis-generative and need to be confirmed with prospective clinical trials.” – by Melissa Foster
Disclosure: The authors report no relevant financial disclosures.
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