Metrics of Gender Differences in Mortality Risk after Diabetic Foot Disease

Area of Science:

• Medical research
• Public health
• Epidemiology

Background:

• Diabetic foot disease (DFD) presents a significant mortality risk.
• Men are disproportionately affected by DFD.
• Understanding gender-specific mortality in DFD is crucial.

Purpose of the Study:

• To investigate gender disparities in mortality risk among individuals with diabetic foot disease (DFD).
• To compare mortality risks between men and women with DFD and the general population.

Main Methods:

• Retrospective survival analysis using Kaplan-Meier and Cox proportional-hazards models (2011-2018, Tuscany, Italy).
• Evaluation of gender differences in mortality risk (Ratio of Hazard Ratios) in two cohorts: initial DFD hospitalization (n=11,529) and prior DFD hospitalization history (n=11,246).

Main Results:

• Women with DFD exhibited lower survival probabilities in both cohorts.
• Following initial DFD hospitalization, men faced an 18% higher mortality risk compared to women.
• This increased male mortality risk was linked to amputations, ulcers, infections, gangrene, and Charcot, with less benefit from revascularization in men.
• In the cohort with prior DFD hospitalizations, gender mortality differences were minimal, except for a higher risk of minor amputations in men.

Conclusions:

• Overall survival probability in DFD patients is lower for women.
• Men with DFD have a higher mortality risk after their first hospitalization compared to those without DFD.
• This elevated male mortality risk diminishes in patients with a history of DFD, potentially due to a higher proportion of older, more diabetic women in this group.