Marital Status and Clinical Outcomes in Chronic Limb-Threatening Ischemia

Chronic limb threatening ischamia (CLTI) represents the most severe manifestation of peripheral arterial disease with high mortality and healthcare costs. While clinical risk factors are established, the influence of social factors is less well defined. This study aimed to evaluate the association between marital and clinical outcomes in patients one year following index admission with CLTI.

A retrospective observational analysis was conducted of all primary CLTI admissions to a tertiary vascular center between 2019 and 2022. Demographic, clinical, and outcome data was extracted from electronic medical records. The primary endpoints were the occurrence of major adverse limb events, major adverse cardiac events, and mortality within a year of admission.

During the study period, 278 patients were treated for CLTI with information on relationship status available for 271. The mean age was 71.2 y and 66.5% (N = 185/278) of the patients were men. Of the study population, 48% were married (N = 130/271) with 19.2% single (N = 52/271), 16.6% widowed (N = 45/271) and 16.2% divorced (N = 44/271). No statistically significant association was found between marital status and rates of major adverse limb events (P = 0.943), amputation (P = 0.304), major adverse cardiac events (P = 0.302), or mortality (P = 0.626). However, unmarried patients demonstrated higher proportions of major amputation (21.5% versus 16.5%, P = 0.304) and readmission (46% versus 38%, P = 0.610).

In this cohort, marital status was not independently associated with major adverse limb, cardiovascular, or mortality outcomes at one year. Nonetheless, the observed trends suggest potential influences on recovery, treatment adherence, and revascularization patterns. This highlights the need for further research to better understand the complex interaction between social determinants and clinical outcomes in CLTI.