Amputation rate higher for nonwhites with leg ischemia

New research shows that race may be a factor as to whether a patient with lower extremity ischemia would undergo an amputation or receive revascularization. The study, published in JAMA Surgery, found that nonwhite patients were more likely to receive an amputation compared with white patients with the same condition.

The study identified 774,399 patients from the Nationwide Inpatient Sample who were treated for critical lower extremity ischemia between 2002 and 2008. The researchers found that 56% of nonwhite patients and 35% of white patients received an amputation.

After controlling for confounding factors, such as access to hospital care, differences in hospital resources and socioeconomic status, the researchers still found that the odds of receiving an amputation increased for nonwhite patients, and the disparity was highest for patients living in wealthier ZIP codes.

“Contrary to current beliefs that the disparity is mainly secondary to differences in access, this study found that the disparity was magnified in settings where resources were greatest,” the authors wrote in the study abstract. “Whether the explanation lies primarily in patient-specific, physician-specific, or institutional-specific factors remains to be determined, but is critical to better understanding our health care system and maintaining approaches that are consistently fair and equitable.”

For more information:

Durazzo TS.JAMA Surg. 2013; doi:10.1001/jamasurg.2013.1436.

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