title: Mortality following lower extremity amputation in minorities with diabetes mellitus.
abstract: The aim of this study was to identify the age adjusted and level specific mortality rate in African-Americans, Hispanics and non-Hispanic whites (NHW) during the perioperative period following a lower extremity amputation. We identified amputation data obtained from the Office of Statewide Planning and Development in California for 1991 from ICD-9-CM codes 84.11-84.18 and diabetes mellitus from any 250 related code. Amputations were categorized as foot (84.11-84.12), leg (84.13-84.16) or thigh (84.17-84.18). Death was coded under discharge status. Age adjusted and level specific mortality rates per 1000 amputees were calculated for each race/ethnic group. The age adjusted mortality was highest for African-Americans (41.39) compared to Hispanics (19.69) and NHW's (34.98). Mortality was consistently more frequent for proximal amputations. We conclude that mortality rates for persons with diabetes hospitalized for an amputation varied by race, gender and level of amputation. Higher prevalence or severity of risk factors may explain the excess mortality observed in African-Americans.
authors.affiliation: Department of Orthopaedics, University of Texas Health Science Center, San Antonio 78284-7776, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Lavery
authors.forename: W H
authors.initials: WH
authors.lastname: van Houtum
authors.forename: D G
authors.initials: DG
authors.lastname: Armstrong
authors.forename: L B
authors.initials: LB
authors.lastname: Harkless
authors.forename: H R
authors.initials: HR
authors.lastname: Ashry
authors.forename: S C
authors.initials: SC
authors.lastname: Walker
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000671:Amputation, Surgical / Q000401:mortality* / Q000706:statistics & numerical data; D044383:Black People; D002140:California; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000401:mortality*; D005260:Female; D005528:Foot; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D012044:Regression Analysis; D013848:Thigh; D044465:White People / Q000706:statistics & numerical data