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Print this pageRR19. Racial/Ethnic Disparities in Amputation for Acute Peripheral Arterial Disease in the United States, 1998-2006
Vincent L. Rowe1, Fred A. Weaver1, Christian Ochoa1, John S. Lane, III2, David A. Etzioni1
1Keck School of Medicine at USC, Los Angeles, CA; 2University of California, Irvine, Irvine, CA
OBJECTIVES: Prior studies have documented racial/ethnic disparities in rates of amputations for peripheral arterial disease (PAD) in the United States (U.S.). We analyze the extent to which these disparities persist during an era that has seen significant growth in the use of endovascular therapy.
METHODS: The 1998-2006 Nationwide Inpatient Sample was used to examine patterns of treatment. We considered a hospitalization as an acute admission for PAD if 1) the primary diagnosis was PAD, and 2) the patient was admitted urgently/emergently or through an ER. Vascular interventions were designated as open bypass, endovascular intervention, or major amputation (disarticulation at ankle or higher amputation).
RESULTS: Between 1998 and 2006, likelihood of an endovascular procedure being performed during an acute hospitalization for PAD increased from 11.5% to 35.3%; open vascular procedure decreased from 34.9% to 25.4% (Figure 1). Likelihood of major amputation during an acute hospitalization for PAD decreased from 29.7% to 20.3%. Black and Hispanic patients were more likely than whites to undergo amputation (Table 1).
CONCLUSIONS: Use of endovascular procedures has increased and use of open vascular bypass has decreased in the inpatient treatment of acute PAD. While overall likelihood of amputation has decreased, racial/ethnic disparities persist, with black and Hispanic patients experiencing higher likelihood of amputation.
AUTHOR DISCLOSURES: V.L. Rowe, None; F.A. Weaver, None; C. Ochoa, None; J.S. Lane, None; D.A. Etzioni, None.
Figure 1.
Table 1.
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