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Metrics of Gender Differences in Mortality Risk after Diabetic Foot Disease
Background: The aim of this study was to clarify any gender differences in the mortality risk of people with DFD since patients with diabetic foot disease (DFD) are at a high risk of mortality and, at the same time, are more likely to be men. Methods: From regional administrative sources, the surviv...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179088/ https://www.ncbi.nlm.nih.gov/pubmed/37176728 http://dx.doi.org/10.3390/jcm12093288 |
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author | Seghieri, Giuseppe Gualdani, Elisa Francia, Piergiorgio Campesi, Ilaria Franconi, Flavia Di Cianni, Graziano Francesconi, Paolo |
author_facet | Seghieri, Giuseppe Gualdani, Elisa Francia, Piergiorgio Campesi, Ilaria Franconi, Flavia Di Cianni, Graziano Francesconi, Paolo |
author_sort | Seghieri, Giuseppe |
collection | PubMed |
description | Background: The aim of this study was to clarify any gender differences in the mortality risk of people with DFD since patients with diabetic foot disease (DFD) are at a high risk of mortality and, at the same time, are more likely to be men. Methods: From regional administrative sources, the survival probability was retrospectively evaluated by the Kaplan-Meier method and using the Cox proportional-hazards model comparing people with DFD to those without DFD across the years 2011–2018 in Tuscany, Italy. Gender difference in mortality was evaluated by the ratio of hazard ratios (RHR) of men to women after initial DFD hospitalizations (n = 11,529) or in a cohort with prior history of DFD hospitalizations (n = 11,246). Results: In both cohorts, the survival probability after DFD was lower among women. Compared to those without DFD, after initial DFD hospitalizations, the mortality risk was significantly (18%) higher for men compared to women. This excess risk was particularly high after major amputations but also after ulcers, infections, gangrene, or Charcot, with a lower reduction after revascularization procedures among men. In the cohort that included people with a history of prior DFD hospitalizations, except for the risk of minor amputations being higher for men, there was no gender difference in mortality risk. Conclusions: In people with DFD, the overall survival probability was lower among women. Compared to those without DFD after a first DFD hospitalization, men were at higher risk of mortality. This excess risk disappeared in groups with a history of previous DFD hospitalizations containing a greater percentage of women who were older and probably had a longer duration of diabetes and thus becoming, over time, progressively frailer than men. |
format | Online Article Text |
id | pubmed-10179088 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-101790882023-05-13 Metrics of Gender Differences in Mortality Risk after Diabetic Foot Disease Seghieri, Giuseppe Gualdani, Elisa Francia, Piergiorgio Campesi, Ilaria Franconi, Flavia Di Cianni, Graziano Francesconi, Paolo J Clin Med Article Background: The aim of this study was to clarify any gender differences in the mortality risk of people with DFD since patients with diabetic foot disease (DFD) are at a high risk of mortality and, at the same time, are more likely to be men. Methods: From regional administrative sources, the survival probability was retrospectively evaluated by the Kaplan-Meier method and using the Cox proportional-hazards model comparing people with DFD to those without DFD across the years 2011–2018 in Tuscany, Italy. Gender difference in mortality was evaluated by the ratio of hazard ratios (RHR) of men to women after initial DFD hospitalizations (n = 11,529) or in a cohort with prior history of DFD hospitalizations (n = 11,246). Results: In both cohorts, the survival probability after DFD was lower among women. Compared to those without DFD, after initial DFD hospitalizations, the mortality risk was significantly (18%) higher for men compared to women. This excess risk was particularly high after major amputations but also after ulcers, infections, gangrene, or Charcot, with a lower reduction after revascularization procedures among men. In the cohort that included people with a history of prior DFD hospitalizations, except for the risk of minor amputations being higher for men, there was no gender difference in mortality risk. Conclusions: In people with DFD, the overall survival probability was lower among women. Compared to those without DFD after a first DFD hospitalization, men were at higher risk of mortality. This excess risk disappeared in groups with a history of previous DFD hospitalizations containing a greater percentage of women who were older and probably had a longer duration of diabetes and thus becoming, over time, progressively frailer than men. MDPI 2023-05-05 /pmc/articles/PMC10179088/ /pubmed/37176728 http://dx.doi.org/10.3390/jcm12093288 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Seghieri, Giuseppe Gualdani, Elisa Francia, Piergiorgio Campesi, Ilaria Franconi, Flavia Di Cianni, Graziano Francesconi, Paolo Metrics of Gender Differences in Mortality Risk after Diabetic Foot Disease |
title | Metrics of Gender Differences in Mortality Risk after Diabetic Foot Disease |
title_full | Metrics of Gender Differences in Mortality Risk after Diabetic Foot Disease |
title_fullStr | Metrics of Gender Differences in Mortality Risk after Diabetic Foot Disease |
title_full_unstemmed | Metrics of Gender Differences in Mortality Risk after Diabetic Foot Disease |
title_short | Metrics of Gender Differences in Mortality Risk after Diabetic Foot Disease |
title_sort | metrics of gender differences in mortality risk after diabetic foot disease |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179088/ https://www.ncbi.nlm.nih.gov/pubmed/37176728 http://dx.doi.org/10.3390/jcm12093288 |
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