title: Racial/ethnic disparities in amputation and revascularization: a nationwide inpatient sample study.
abstract: This study investigates whether ethnic minorities presenting with critical limb ischemia (CLI) are more likely to undergo major limb amputation compared to white patients. The Nationwide Inpatient Sample (NIS) database was used to identify all patients admitted with CLI; lower extremity revascularization; and major lower extremity amputation from 1998 to 2005. The NIS identified 240 139 patients presenting with CLI--68.2% white, 19.5% black, 9.0% Hispanic, and 1.24% Asian. In all, 83 328 patients underwent revascularization--73.7% white, 15.9% black, 7.4% Hispanic, and 1.1% Asian. The majority of the interventions were open. In all, 111 548 patients underwent a major lower extremity amputation--61% white, 25.4% black, 10.1% Hispanic, and 1.1% Asian. The mean Charlson comorbidity scores for amputation were 2.1 for whites, 2.0 for blacks, 2.3 for Hispanics, and 2.5 for Asians (for all data, P < .05). Blacks make up a disproportionately higher proportion of patients admitted for CLI and undergoing amputation, with a lower proportion undergoing revascularization.
authors.affiliation: 1Department of Surgery, Howard University, Washington, DC, USA.
authors.forename: Kakra
authors.initials: K
authors.lastname: Hughes
authors.forename: Shiva
authors.initials: S
authors.lastname: Seetahal
authors.forename: Toluloupe
authors.initials: T
authors.lastname: Oyetunji
authors.forename: David
authors.initials: D
authors.lastname: Rose
authors.forename: Wendy
authors.initials: W
authors.lastname: Greene
authors.forename: David
authors.initials: D
authors.lastname: Chang
authors.forename: Edward
authors.initials: E
authors.lastname: Cornwell
authors.forename: Thomas
authors.initials: T
authors.lastname: Obisesan
mesh_terms: D001741:Black or African American; D000671:Amputation, Surgical; D044466:Asian People; D015897:Comorbidity; D016638:Critical Illness; D057510:Endovascular Procedures; D005006:Ethnicity; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans; D007297:Inpatients; D007511:Ischemia / Q000175:diagnosis / Q000208:ethnology / Q000601:surgery / Q000628:therapy*; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D008913:Minority Groups; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D044465:White People
keywords: amputation; comorbidities; limb ischemia; racial disparity; revascularization