title: Gender related Long-term Differences after Open Infrainguinal Surgery for Critical Limb Ischemia.
abstract: OBJECTIVE
  The role of gender on long-term infrainguinal open surgery outcomes still remains uncertain in critical limb ischemia patients. The aim of this study is to evaluate the gender-specific differences in patient characteristics and long-term clinical outcomes in terms of survival, primary patency and limb salvage among patients undergoing infrainguinal open surgery for CLI.
  
  
  METHODS
  All consecutive patients undergoing infrainguinal open surgery for critical limb ischemia between 2003 and 2012 were included. Survival, limb salvage and primary patency rates were assessed. Independent outcome determinants were identified by the Cox proportional hazard ratio using age and gender as adjustment factors.
  
  
  RESULTS
  584 patients (269 women and 315 men, mean age 76 and 71 years respectively) underwent 658 infrainguinal open surgery (313 in women and 345 in men). Survival rate at 6 years was lower among women compared to men with 53.5% vs 70.9% (p < 0.001). The same applied to primary patency (35.9% vs 52.4%, p < 0.001) and limb salvage (54.3% vs 81.1%, p < 0.001) at 6 years. Female-gender was an independent factor predicting death (hazard ratio 1.50), thrombosis (hazard ratio 2.37) and limb loss (hazard ratio 7.05) in age and gender-adjusted analysis.
  
  
  CONCLUSIONS
  Gender-related disparity in critical limb ischemia open surgical revascularization outcomes still remains.
authors: Department of Vascular Surgery and Kidney Transplantation, University Hospital, Strasbourg, France. Electronic address: anne-catherine.lejay@orange.fr.
authors: A
authors: A
authors: Lejay
authors: Clinical Research Methodology Group, Service of Public Health, University Hospital, Strasbourg, France.
authors: M
authors: M
authors: Schaeffer
authors: Department of Vascular Surgery and Kidney Transplantation, University Hospital, Strasbourg, France.
authors: Y
authors: Y
authors: Georg
authors: Department of Vascular Surgery and Kidney Transplantation, University Hospital, Strasbourg, France.
authors: B
authors: B
authors: Lucereau
authors: Department of Vascular Surgery and Kidney Transplantation, University Hospital, Strasbourg, France.
authors: M
authors: M
authors: Roussin
authors: Department of Vascular Surgery and Kidney Transplantation, University Hospital, Strasbourg, France.
authors: E
authors: E
authors: Girsowicz
authors: Department of Vascular Surgery and Kidney Transplantation, University Hospital, Strasbourg, France.
authors: C
authors: C
authors: Delay
authors: Department of Vascular Surgery and Kidney Transplantation, University Hospital, Strasbourg, France.
authors: A
authors: A
authors: Schwein
authors: Department of Vascular Surgery and Kidney Transplantation, University Hospital, Strasbourg, France.
authors: F
authors: F
authors: Thaveau
authors: Department of Physiology and Functional Explorations, University Hospital, Strasbourg, France.
authors: B
authors: B
authors: Geny
authors: Department of Vascular Surgery and Kidney Transplantation, University Hospital, Strasbourg, France.
authors: N
authors: N
authors: Chakfe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality
keywords: Critical limb ischemia; Gender; Infrainguinal disease; Open surgery