Background: Identifying sex-related differences/variables associated with 30 day/1 year mortality in patients with chronic limb-threatening ischemia (CLTI). Methods: Multicenter/retrospective/observational study. A database was sent to all the Italian vascular surgeries to collect all the patients operated on for CLTI in 2019. Acute lower-limb ischemia and neuropathic-diabetic foot are not included. Follow-up: One year. Data on demographics/comorbidities, treatments/outcomes, and 30 day/1 year mortality were investigated. Results: Information on 2399 cases (69.8% men) from 36/143 (25.2%) centers. Median (IQR) age: 73 (66–80) and 79 (71–85) years for men/women, respectively (
p < 0.0001). Women were more likely to be over 75 (63.2% vs. 40.1%,
p = 0.0001). More men smokers (73.7% vs. 42.2%,
p < 0.0001), are on hemodialysis (10.1% vs. 6.7%,
p = 0.006), affected by diabetes (61.9% vs. 52.8%,
p < 0.0001), dyslipidemia (69.3% vs. 61.3%,
p < 0.0001), hypertension (91.8% vs. 88.5%,
p = 0.011), coronaropathy (43.9% vs. 29.4%,
p < 0.0001), bronchopneumopathy (37.1% vs. 25.6%,
p < 0.0001), underwent more open/hybrid surgeries (37.9% vs. 28.8%,
p < 0.0001), and minor amputations (22% vs. 13.7%,
p < 0.0001). More women underwent endovascular revascularizations (61.6% vs. 55.2%,
p = 0.004), major amputations (9.6% vs. 6.9%,
p = 0.024), and obtained limb-salvage if with limited gangrene (50.8% vs. 44.9%,
p = 0.017). Age > 75 (HR = 3.63,
p = 0.003) is associated with 30 day mortality. Age > 75 (HR = 2.14,
p < 0.0001), nephropathy (HR = 1.54,
p < 0.0001), coronaropathy (HR = 1.26,
p = 0.036), and infection/necrosis of the foot (dry, HR = 1.42,
p = 0.040; wet, HR = 2.04,
p < 0.0001) are associated with 1 year mortality. No sex-linked difference in mortality statistics. Conclusion: Women exhibit fewer comorbidities but are struck by CLTI when over 75, a factor associated with short- and mid-term mortality, explaining why mortality does not statistically differ between the sexes.
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