{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:14:29Z","timestamp":1760058869185,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Peripheral artery disease (PAD) is a progressive atherosclerotic condition associated with significant morbidity and mortality. While PAD prevalence is comparable between sexes, women tend to have worse clinical outcomes, higher rates of disability, and are underdiagnosed and undertreated compared to men. This study examines sex differences in PAD presentation, diagnosis, and treatment outcomes using the Medical Information Mart for Intensive Care (MIMIC)-IV v3.1 database. Methods: A retrospective cohort study was conducted using electronic health records from the MIMIC-IV v3.1 database, identifying patients diagnosed with PAD between 2008 and 2022. Patient selection was based on International Classification of Diseases (ICD)-9 and ICD-10 codes. The following two datasets were constructed: an admission-level dataset (6468 admissions, 3913 unique patients) and a patient-level dataset aggregating multiple admissions per individual. Key variables included demographics, hospitalization details, procedure rates, and clinical outcomes. Sex-based comparisons were performed to assess disparities in disease burden, intervention rates, and mortality. Results: The study cohort comprised 3913 PAD patients. Women were significantly older than men at time of admission (mean 70.78 vs. 68.97 years, p &lt; 0.05) and had lower rates of procedural intervention across all categories, including angioplasty (12.85% vs. 15.39%) and bypass grafting (14.74% vs. 16.98%). Despite similar Intensive Care Unit (ICU) admission rates (30.56% in females vs. 31.73% in males), women experienced greater delays in PAD diagnosis and treatment initiation. The in-hospital mortality rate was comparable between sexes (6.62% vs. 6.92%). Women presented more frequently with atypical or asymptomatic PAD, leading to delays in diagnosis and specialist referrals. Conclusions: This study highlights significant sex disparities in PAD diagnosis and management. Women with PAD are older at diagnosis, receive fewer procedural interventions, and experience delayed clinical recognition, contributing to a higher cumulative disease burden. These findings underscore the need for sex-specific diagnostic criteria, improved clinical awareness, and equitable treatment strategies to optimize PAD outcomes in women.<\/jats:p>","DOI":"10.3390\/jcm14103304","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T06:18:51Z","timestamp":1746771531000},"page":"3304","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex Disparities in PAD Patients: Retrospective Study Utilizing MIMIC-IV v3.1 Database"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3748-294X","authenticated-orcid":false,"given":"Sanaullah","family":"Mojaddedi","sequence":"first","affiliation":[{"name":"Graduate Medical Education, University of Central Florida College of Medicine, Orlando, FL 32827, USA"},{"name":"Internal Medicine Residency Program, HCA Florida North Florida Hospital, Gainesville, FL 32605, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2541-9373","authenticated-orcid":false,"given":"Geran","family":"Maule","sequence":"additional","affiliation":[{"name":"Graduate Medical Education, University of Central Florida College of Medicine, Orlando, FL 32827, USA"},{"name":"Internal Medicine Residency Program, HCA Florida North Florida Hospital, Gainesville, FL 32605, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javairia","family":"Jamil","sequence":"additional","affiliation":[{"name":"College of Medicine, Gulf Medical University, Ajman P.O. Box 4184, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2728-1184","authenticated-orcid":false,"given":"John","family":"Rickards","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Mercer University School of Medicine, Macon, GA 31207, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret K.","family":"Ohama","sequence":"additional","affiliation":[{"name":"The Cardiac and Vascular Institute, Gainesville, FL 32605, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Khraisat","sequence":"additional","affiliation":[{"name":"Graduate Medical Education, University of Central Florida College of Medicine, Orlando, FL 32827, USA"},{"name":"Internal Medicine Residency Program, HCA Florida North Florida Hospital, Gainesville, FL 32605, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdallah","family":"Rayyan","sequence":"additional","affiliation":[{"name":"Graduate Medical Education, University of Central Florida College of Medicine, Orlando, FL 32827, USA"},{"name":"Internal Medicine Residency Program, HCA Florida North Florida Hospital, Gainesville, FL 32605, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Zentko","sequence":"additional","affiliation":[{"name":"Graduate Medical Education, University of Central Florida College of Medicine, Orlando, FL 32827, USA"},{"name":"The Cardiac and Vascular Institute, Gainesville, FL 32605, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1161\/CIR.0000000000001251","article-title":"2024 ACC\/AHA\/AACVPR\/APMA\/ABC\/SCAI\/SVM\/SVN\/SVS\/SIR\/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"149","author":"Gornik","year":"2024","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1161\/CIRCRESAHA.121.320702","article-title":"Sex Differences in Peripheral Artery Disease","volume":"130","author":"Pabon","year":"2022","journal-title":"Circ Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e1020","DOI":"10.1016\/S2214-109X(19)30255-4","article-title":"Global, regional, and national prevalence and risk factors for peripheral artery disease in 2015: An updated systematic review and analysis","volume":"7","author":"Song","year":"2019","journal-title":"Lancet Glob. 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