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Home > Vascular Annual Meeting > PVSS18. Does Gender Still Matter? Time-Trend Analysis...

PVSS18. Does Gender Still Matter? Time-Trend Analysis of Gender Related Differences in the Management of Peripheral Arterial Disease (PAD) in NY, NJ and FL States: 1998-2007

Natalia Egorova, PhD; Ageliki G. Vouyouka, MD; Sharif Ellozy, MD; Daniel Silverberg, MD; Windsor Ting, MD; Victoria Teodorescu, MD; Michael Marin, MD; Peter L. Faries, MD
Mount Sinai Medical Center, New York, NY

OBJECTIVES: Gender- related differences still challenge the management of PAD in women. We analyzed the time-trends of such differences.

METHODS: Data for PAD patients from New York, New Jersey and Florida state hospital discharge databases (1998-2007) were analyzed using univariate and multivariate logistic regression analyses.

RESULTS: The 1,500,000 PAD patient-discharges analyzed showed a slight increase in total PAD admissions and a slight decrease of inpatient procedures for both genders (Fig1 a and b). Compared to men, women had 17-25% fewer PAD admissions and 25-33% fewer vascular procedures (p<0.0001). They were persistently more likely than men to be admitted emergently (75% vs. 71% in 1998 and 80% vs.77% in 2007), to undergo a major amputation, and to be discharged to a nursing home. Over the study period, the amputation rate declined by 50% in women and 33% in men, the number of open procedures decreased by 50% and 41%, while endovascular procedures increased by 95% and 104%, respectively. Overall hospital mortality was marginally higher for women than men (4.74% vs. 4.26%, p<0.0001); but was lower for female octogenarians (6.91% vs.7.26% p<0.0001). Female mortality rates were persistently higher than men for amputations (9.82 % vs. 8.82%, p<0.0001), and open vascular procedures (5.48% vs.4.00%, p<0.0001) but similar to men after endovascular procedures (2.87% vs. 2.10%). Time trends showed improved mortality for both genders with stable difference between the genders.

CONCLUSIONS: Despite improved mortality and amputation rates over time, there is still a gender related disparity in the PAD outcomes that merits further investigation

AUTHOR DISCLOSURES: N. Egorova, None; A.G. Vouyouka, None; S. Ellozy, None; D. Silverberg, MD, W. Ting, None; V. Teodorescu, None; M. Marin, Medtronic; P.L. Faries, None.