title: Racial differences in the incidence of limb loss secondary to peripheral vascular disease: a population-based study.
abstract: OBJECTIVE
  To evaluate racial differences in limb loss caused by peripheral vascular disease in a diverse, statewide population.
  
  
  METHODS
  Retrospective analysis of a cohort of dysvascular amputees.
  
  
  METHODS
  Maryland State Hospital Discharge Data from 1986 to 1997.
  
  
  METHODS
  Persons with a procedure code for lower-limb amputation (ICD9-CM code 84.11-.19) were identified. Patients with limb loss because of trauma, malignancy, or congenital anomalies were excluded.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Incidence rates standardized for age, gender, and race; and time trends.
  
  
  RESULTS
  There were 27,149 discharges with dysvascular amputations, yielding an average annual rate of 44.3 per 100,000 persons. Incidence rates for dysvascular amputations increased from 41.4 per 100,000 in 1986 to 47.2 per 100,000 in 1997. For all levels of amputation, annual incidence rates among African Americans were considerably higher than those of other persons. African Americans were 2 to 4 times more likely to lose a lower limb than white persons of similar age and gender.
  
  
  CONCLUSIONS
  Rising rates of lower-limb amputations in the general population combined with disproportionately higher rates among African Americans are concerning and warrant further investigation into their underlying causes and consequences.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA. tdilling@jhmi.edu
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Dillingham
authors.forename: Liliana E
authors.initials: LE
authors.lastname: Pezzin
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: Mackenzie
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007866:Leg / Q000601:surgery*; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data*