Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Seghieri, Giuseppe, Gualdani, Elisa, Francia, Piergiorgio, Campesi, Ilaria, Franconi, Flavia, Di Cianni, Graziano, Francesconi, Paolo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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
_version_ 1785041015482089472
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
work_keys_str_mv AT seghierigiuseppe metricsofgenderdifferencesinmortalityriskafterdiabeticfootdisease
AT gualdanielisa metricsofgenderdifferencesinmortalityriskafterdiabeticfootdisease
AT franciapiergiorgio metricsofgenderdifferencesinmortalityriskafterdiabeticfootdisease
AT campesiilaria metricsofgenderdifferencesinmortalityriskafterdiabeticfootdisease
AT franconiflavia metricsofgenderdifferencesinmortalityriskafterdiabeticfootdisease
AT diciannigraziano metricsofgenderdifferencesinmortalityriskafterdiabeticfootdisease
AT francesconipaolo metricsofgenderdifferencesinmortalityriskafterdiabeticfootdisease