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In-hospital mortality in patients with acute limb ischemia over a 12-year period in the Brazilian public health-care system. | LitMetric

AI Article Synopsis

  • Arterial diseases pose a significant public health issue, particularly affecting women who display atypical symptoms and worse outcomes compared to men, leading to severe emergencies like acute limb ischemia (ALI).
  • A study analyzing ALI emergencies in Brazil from 2008 to 2019 found that 56.8% of urgent hospitalizations were men, but women had higher in-hospital mortality rates and lower survival rates, especially those over 50 years old.
  • The findings suggest that women, particularly older ones, face worse prognoses in ALI emergencies, prompting the need for further research to understand these disparities better.

Article Abstract

Background: Arterial diseases represent a severe public health problem in the 21st century. Although men have a higher overall prevalence, reports have suggested that women may exhibit atypical manifestations, be asymptomatic, and have hormonal peculiarities, resulting in worse outcomes and severe emergencies, such as acute limb ischemia (ALI).

Objectives: To analyze the morbidity and mortality profile of ALI emergencies in Brazil between 2008 and 2019.

Methods: An ecological study was carried out with secondary data from SIH/SUS, using ICD-10 code I.74 The proportions of emergency hospital admissions and in-hospital mortality rates (HMR) by gender, ethnicity, and age were extracted from the overall figures. P<0.05 was considered significant.

Results: From 2008 to 2019, there were 195,567 urgent hospitalizations due to ALI in Brazil, 111,145 (56.8%) of which were of men. Women had a higher HMR (112:1,000 hospitalizations) than men (85:1,000 hospitalizations) (p<0.05), and a higher chance of death (OR=1.36; p<0.05). Furthermore, mean survival was significantly higher among men (8,483/year versus 6,254/year; p<0.05). Stratified by ethnicity, women who self-identified as white (OR=1.44; p<0.05), black (OR=1.33; p<0.05), and brown (RR=1.25; p <0.05) had greater chances of death than men in the same ethnicity categories. Moreover, women over the age of 50 years had a higher chance of death, with a progressive increment in risk as age increased.

Conclusions: There was a trend to worse prognosis in ALI emergencies associated with women, especially in older groups. The literature shows that the reasons for these differences are still poorly investigated and more robust studies of this relevant disease in the area of vascular surgery are encouraged.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8759584PMC
http://dx.doi.org/10.1590/1677-5449.210107DOI Listing

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