title: Do Women Have Worse Amputation-Free Survival Than Men Following Endovascular Procedures for Peripheral Arterial Disease? An Evaluation of the California State-Wide Database.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Vascular and Endovascular Surgery, University of California Davis Medical Center, CA, USA nhedayati@ucdavis.edu.
authors.forename: Nasim
authors.initials: N
authors.lastname: Hedayati
authors.affiliation: Department of Internal Medicine, University of California, Davis Medical Center, CA, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Brunson
authors.affiliation: Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, Sacramento, CA, USA.
authors.forename: Chin-Shang
authors.initials: CS
authors.lastname: Li
authors.affiliation: Division of Vascular and Endovascular Surgery, University of California Davis Medical Center, CA, USA.
authors.forename: Aaron C
authors.initials: AC
authors.lastname: Baker
authors.affiliation: Division of Vascular and Endovascular Surgery, University of California Davis Medical Center, CA, USA.
authors.forename: William C
authors.initials: WC
authors.lastname: Pevec
authors.affiliation: Department of Internal Medicine, University of California, Davis Medical Center, CA, USA.
authors.forename: Richard H
authors.initials: RH
authors.lastname: White
authors.affiliation: Department of Internal Medicine, University of California, Davis Medical Center, CA, USA.
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Romano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000009:adverse effects / Q000401:mortality; D002140:California; D016009:Chi-Square Distribution; D016208:Databases, Factual; D018572:Disease-Free Survival; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000401:mortality / Q000628:therapy*; D016016:Proportional Hazards Models; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: endovascular; gender; outcomes; peripheral arterial