title: Race independently impacts outcome of infrapopliteal bypass for symptomatic arterial insufficiency.
abstract: The impact of racial background on the outcome of lower extremity revascularization is unknown because a majority of studies have a preponderance of white patients. The charts of patients between 1988 and 2004 requiring infrapopliteal lower extremity revascularization were reviewed. Life-table analyses, the Cox proportional hazards model, and log-rank test were used to calculate graft patency and limb salvage. Bypasses were performed on 236 limbs in 225 patients. Mean follow-up was 18 +/- 1.5 months. Twenty-eight (12%) bypasses were performed on whites, 43 (18%) on African Americans, 148 (63%) on Hispanics, and 17 (7.2%) on patients of other races. African American race negatively correlated with primary-assisted patency (hazard ratio 2.9, P = .03), secondary patency (hazard ratio 3.64, P = .02), and limb salvage (hazard ratio 8, P = .006) compared with whites. African American race has a negative impact on the long-term outcome of infrapopliteal revascularization, regardless of disease stage or associated risk factors.
authors.affiliation: Department of Surgery, Division of Vascular Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA. vrowe@surgery.usc.edu
authors.forename: Vincent L
authors.initials: VL
authors.lastname: Rowe
authors.forename: S Ram
authors.initials: SR
authors.lastname: Kumar
authors.forename: Holly
authors.initials: H
authors.lastname: Glass
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Hood
authors.forename: Fred A
authors.initials: FA
authors.lastname: Weaver
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000714:Anastomosis, Surgical; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000208:ethnology* / Q000209:etiology / Q000503:physiopathology; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D015993:Life Tables; D023821:Limb Salvage / Q000706:statistics & numerical data; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000208:ethnology / Q000503:physiopathology / Q000601:surgery*; D011150:Popliteal Artery / Q000503:physiopathology / Q000601:surgery*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D014680:Veins / Q000637:transplantation; D044465:White People / Q000706:statistics & numerical data*